It’s widely known that CPR done promptly, along with use of an automated external defibrillator, greatly improves chances to save lives during a cardiac arrest. Yet, the majority of cardiac arrest victims never get that help. There are isolated communities across the country, such as Seattle and The Villages, that have taken steps to greatly improve the odds of residents surviving a cardiac arrest. Yet, despite 45 years of relative documented success in places like King County, Washington, the cardiac survival rate is slow to advance across the country in areas that track it and still a mystery in areas that don’t because it’s not required. Here are five things communities can do.
Get organized and get training
Organize more neighborhoods to be trained in CPR and AED like in The Villages. Nationwide, roughly 70 percent of all cardiac arrests occur in the home. To target this, The Villages’ “Neighbors Saving Neighbors” program trains residents in CPR and AED use and then immediately alerts them when a 911 call comes in to respond to their neighbor’s home with the group’s closest AED, often saving valuable minutes before first responders arrive. Across The Villages, 213 neighborhood programs, with 498 AEDs and counting, provide coverage for 16,000 to 18,000 homes. The program is citizen-initiated with training and support from The Villages Public Safety Department, the local paramedic service and fire department. Residents for a specific area come together to raise the funds to purchase AED devices, train, do drills and ultimately become available to respond to all cardiac emergencies reported in their defined coverage area. “I’ve not seen a program that has as much as promise as this one,” said Dr. Kenneth Scheppke, Florida’s EMS medical director.
Require nationwide cardiac arrest reporting
Push EMS agencies and hospitals to report data on cardiac arrests to a national registry or government agency. Such tracking would allow the rest of the nation to learn from the communities that perform the best and, potentially, improve cardiac survival rates. The federal Centers for Disease Control and Prevention can clearly define the location and severity of flu outbreaks and detail deaths from various diseases, but its Cardiac Arrest Registry to Enhance Survival (CARES) doesn’t identify high-performing or struggling communities when it comes to out-of-hospital cardiac survivor rates because of confidentiality concerns. However, it is designed to provide communities with performance benchmarks to better identify opportunities to improve. CARES works with communities representing a total of 115 million people, or about one-third of nation’s population — a good enough sample size to realize that a 10.4% cardiac save rate is dismal, according to experts. Having greater participation would only aid analysis of sudden cardiac arrest care and help improve treatment.
Embrace new technology and alert systems
Encourage more communities to adopt programs like PulsePoint that seek to instantly alert and connect CPR/AED-trained people to those in cardiac distress in their immediate public area, as well as advise where the nearest registered AED is located. The service is available in The Villages and all of Sumter County, but not Lake or Marion counties outside of The Villages. These simple, free phone apps have the ability to make a difference nationally, but there are big hurdles to making them effective. First, the public must be CPR/AED-trained, have the app installed and set it to receive cardiac arrest alerts. Secondly, local EMS, hospital and public safety agencies must be willing to invest in the work to connect the phone application with its 911 dispatch system so public alerts go out the same moment EMS crews are dispatched. There’s PulsePoint Respond to receive “CPR needed alerts” and PulsePoint AED to serve as registry of AED locations. The apps are available for both iPhone and Android devices. More than 1,800 users are set up for alerts in Sumter County.
Make AED registration mandatory
Require mandatory registration of AEDs so their locations can be available to 911 call takers to share with potential rescuers. Registration also would allow communities to gauge whether they are deficient in AED availability. In some states, such as Washington, if you own an AED, you must report its location to your local EMS agency so it may record where it is. The law doesn’t ensure 100% compliance, but recording as many devices as possible places them in a database. State of Washington AED owners also are required to report when they use the device. In cities like Boston, which has a database of roughly 1,000 AEDs, 911 call takers are allowed to alert potential rescuers to the availability of an AED device nearby. Florida does not currently require mandatory AED registration; it only “encourages” AED owners to notify the local EMS director or public safety agency, as well as “encourages” them to obtain appropriate training, including “demonstrated proficiency in the use of an automated external defibrillator.”
Bring lifesaving training to schools
Create an entire generation of people trained to save lives by requiring certification in CPR and AED for a high school diploma. Currently, 39 states have that requirement, according to the American Heart Association, but Florida is not one of them. One of the gravest concerns emerging out of a 2015 report by the Institute of Medicine’s committee on the treatment of cardiac arrestwas “each year less than 3% of the U.S. population receives CPR training, leaving many bystanders unprepared to respond to cardiac arrest.” The committee recommended that state and local education departments include CPR and AED training as middle- and high-school graduation requirements. A bill proposing to make it a requirement in Florida is currently filed. The Sunshine State boasts roughly than 2.7 million high school students, which would create a significant CPR/AED-trained population. Some schools in the state already provide CPR training for students, such as The Villages High School, where ninth-grade students receive training and health academy students repeat for certification purposes.