(continued from page 15)
er-based medical triage algorithm utilized by call-takers in the MetroSafe 911 Communications Center, include a small percentage of
cardiac arrests as well as respiratory arrests - those patients who are
unable to breathe effectively on their own and who, therefore, may
soon deteriorate into cardiac arrest. More than three-fourths of the
cardiac and respiratory arrests occurring each year in Louisville are,
however, not categorized within this ECHO-level classification. This
means that for the vast majority of patients suffering from cardiac
or respiratory arrest, access to rapid CPR and defibrillation from a
trained first-responder is severely limited.
From July 2013 to June 2014, LMEMS responded to approximately
one thousand patients in cardiac and respiratory arrest. Only 24
percent of those calls were categorized as ECHO-level responses,
which means that approximately three-quarters of those patients
in the SFDs did not have access to a first-responder as they would
elsewhere in this country or, in fact, in certain other parts of the
County and Urban District, thereby dramatically decreasing their
chances of survival
links in the current chain of survival. By providing improved service
in the out-of-hospital environment, we’re able better to position
the patient for a positive outcome once they arrive at the hospital.
For more information about the proper way to perform CPR,
visit www.whas11.com/videos/news/local/2014/10/14/15776018.
Note: All of the authors are members of Louisville Metro EMS, the 911
Emergency Medical Services system that serves Louisville/Jefferson
County. Neal Richmond, MD, is Chief Executive Officer and Medical
Director, Ben Neal is a paramedic (EMT-P) who coordinates the Cardiac Arrest Management Program. Major Michael Tully (EMT -B)
directs the Office of Management Analysis. Planning and Logistics.
Kristen Miller (J.D.) is Chief of Staff.
In an effort to remedy this situation and to provide critical emergency medical first- response in those suburban districts which are
currently providing limited first-response capability, LMEMS has
implemented an innovative pilot project that employs rapid response
vehicles, or “fly cars,” to our regular deployment each day. These
fly-cars are not ambulances – they are SUVs operated by a single
Emergency Medical Technician (EMT) who is equipped with a
medical kit and defibrillator. During LMEMS’ busiest hours of the
day, six fly cars are deployed across the suburban areas of the city
and dispatched on potentially life-threatening emergency medical
calls. Their mission is to respond quickly and stabilize patients,
providing basic life support care until an LMEMS ambulance arrives on-scene. At that point, the EMT fly car returns to the street,
ready to respond to the next critically ill patent dispatched by 911.
Since implementing this pilot in July, LMEMS’ fly cars have responded to almost 1,200 emergency medical calls. Most importantly,
these six resources have responded to 38 percent of the OOHCAs
that would now otherwise receive no first-response, with an average
response time to those calls of just more than five minutes. The goal
of this initiative is to reach as many cardiac and respiratory arrest
patients as possible and tighten, as much as possible, those weak
Louisville’s emergency personnel recently underwent enhanced personal protective equipment (PPE) training for better Ebola preparedness in
addition to their efforts with cardiac arrest response.
DECEMBER 2014
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