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or By John Erich, Associate Editor SCA: 25 Steps to Ending Survival Envy Perhaps you live in a community where take or contribute to some relatively “It helps explain what’s happening,” the sudden cardiac arrest survival rate resource-light actions that are likely to Eisenberg says. “You feel like you’re there is especially modest. Maybe you look raise your community’s survival rate for in the living room, with all the distractions with envy at places like Rochester, MN, cardiac arrest.” and dogs barking and chaos that occurs. where, over 13 years, an impressive We consider it a vital part of reconstruct- 46% of those experiencing witnessed DO NOW ing. It also helps answer questions about ventricular fibrillations ultimately lived to Easiest among those are the first five timing, like when CPR began.” hospital discharge, or King Co., WA, which steps Eisenberg outlines, which can be achieved the same rate for that group done immediately and without much dif- DO LOCALLY earlier this decade. You might despair ficulty. These are: The next 10 measures constitute a local that your jurisdiction will never savor such 1) Establish rapid dispatch—Get the action plan. They include: success, even among the witnessed v-fib closest EMT vehicles to 9-1-1 calls en 6–8) Political, administrative and medi- subset of cardiac arresters most ame- route, even as the dispatcher gathers fur- cal leadership—The specifics of these nable to saving. ther information. areas differ, but in general, to raise SCA Maybe, maybe not. But you can do 2) Dispatcher CPR instructions—It’s survival, you’ll need good leaders. “Unless better than you do now, and one of the important to give them, but don’t stop you have leadership, everything else is a architects of King County’s success wants there. Audit calls and provide feedback. nonstarter,” Eisenberg says. “It’s like the to tell you how. “You have to listen to every cardiac arrest catalytic agent to make everything else In his new book, Resuscitate! How Your Community Can Improve Survival From Sudden Cardiac Arrest, King County EMS Even one or two motivated leaders attacking one Medical Director Mickey Eisenberg, MD, or two challenges, Eisenberg says, can yield an PhD, articulates 25 steps to take that will help communities improve their cardiac important difference in outcomes. arrest survival rates. “The goal was to give concrete sug- gestions, rather than nice-sounding tape—those where instructions were possible. It’s a mysterious quality that’s platitudes,” says Eisenberg, a professor of given and those where they weren’t,” difficult to quantitate, but when it’s there, medicine at the University of Washington. Eisenberg says. “If they weren’t given, is amazing things can be achieved.” Good “I figured if I were the manager of an EMS there a teaching point to make it possible leadership in even one of these areas can system, I’d want practical suggestions, next time? If they were done, were they help get things rolling. not abstract theory about why some com- done properly? Were there delays you 9) Establish tiered response—Consider munities succeed and others don’t.” can reduce? Unless you scrutinize the arming first responders like police with The resulting measures are indeed con- dispatch aspect of the cardiac arrest as AEDs and training them in CPR. crete, but come with an important caveat: well as the run report, you’re not doing a 10) Comprehensive cardiac arrest Communities
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