data collection and analysis process to gather more than sixty data
points from each cardiac arrest. This includes the time to arrival of
the first response unit on-scene, the total amount of time a crew is
on-scene, the time to defibrillation and placement of an advanced
airway, and a record of intravenous pharmacologic agents administered. This data is used to assemble a dashboard of individual
metrics and system performance measures.
Research shows that with every minute that passes, from the
time a patient collapses to the time resuscitation is initiated, there
is a 10 percent decrease in the likelihood of survival. A successful
outcome is therefore much more likely when immediate life-saving
measures are taken and when, in particular, bystander CPR (b-CPR)
is performed on-scene.
The reality, however, is that the majority of cardiac arrests occur
in the home, and since most people are not trained in CPR, most
patients lose critical minutes until a trained responder arrives onscene.
Only a quarter of OOHCA patients in Louisville do, in fact,
currently receive b-CPR, something that we are acting to remedy
with the American Heart Association (AHA) and other advocacy
groups, specifically by making CPR a requirement for high school
graduation - a compelling initiative for the coming legislative session in Frankfort. In addition, Louisville has now been chosen by
the AHA as one of four cities in the U.S. to pilot a new program to
demonstrate the benefits of introducing hands-only CPR training
programs in communities that have disproportionately high rates of
cardiac arrest and low rates of b-CPR, something that often parallels
populations of lower socioeconomic status.
To address this situation not only in Louisville, but in communities throughout the U.S. and the rest of the developed world, Fire
services play a vital role in providing first-response to 911 medical
emergencies. With fire stations and personnel strategically positioned throughout the community, a Fire first-responder may be able
to arrive minutes before an ambulance, and thereby initiate care to
stabilize, specifically by performing early CPR, rapid defibrillation
and airway management.
To put this in perspective, LMEMS ambulances respond on average to all 911 emergency calls-for-service in just less than eight
minutes, while responses to cardiac arrest patients typically take
between six and eight-minutes. While that may sound reasonable,
we know that patient survival drops off dramatically at about four
to five-minutes. Fire Departments throughout the County are typically configured and available to get to these patients in the narrow
time window necessary for successful resuscitation, and are then
backed up by an ambulance crew that can provide more advanced
and definitive care.
In Louisville, access to Fire first-responders is limited and may
vary depending on where a patient lives. While LMEMS provides
emergency medical response to patients throughout the entirety
of Louisville’s 386-square mile area, Fire first-respon ͔