Waking the Dead

by Jason Busch
Created:

EMS World Expo 2012 keynote address focused on rethinking our approach to sudden cardiac arrest


EMS World’s 2012 Expo was welcomed back to the city of New Orleans with open arms and jazz music—not to mention a little disco.

That’s because, as every EMS provider should know by now, the Bee Gees iconic “Stayin’ Alive” has the perfect beat to perform chest compressions to.

And staying alive is just what keynote speaker Ed Racht, MD and chief medical officer for American Medical Response, wanted to talk about with the thousands of providers in attendance.

Racht was quick to point out “Rethinking Our Approach to Sudden Cardiac Arrest” wasn’t the most captivating title for his presentation. Instead, he offered “Waking the Dead,” which was perfect for a presentation taking place on Halloween.

“In the U.S., 383,000 people suffer an out-of-hospital cardiac arrest each year,” Racht said.

Fifty years ago we developed CPR, he explained. Then we had a bunch of variations on the method of restarting the heart—many, thankfully, no longer in use. Then things got complex, as we added numbers and algorithms.

“We developed all these things, but survival rates stayed the same,” Racht said. “We know more about cardiac arrest today than ever before; now what can we do to increase survivability?”

One thing, according to Racht, is changing perceptions. With a remarkable show of hands from audience members, Racht demonstrated the overwhelming number of providers who feel like the act of resuscitation is often just working on a dead body. “We expect this population is, unfortunately, doomed not to survive.”

But he pointed to advances in recent years coming out of several states. First was Arizona, where providers moved to compression-only CPR and saw dramatic increases in resuscitation and survivability. Other places like Seattle and Rochester, MN, have also found success using innovative methods to boost survival rates.

However, sudden cardiac arrest (SCA) survival rates nationwide still hover around 8%, largely unchanged in the past 20 years. Enter the Heart Rescue Project.

Racht explained the Heart Rescue Project’s ambitious goal—improving SCA survival rates by 50% over the next five years, nationwide—involves everyone: bystanders, prehospital and hospital providers, alike.

“We are much stronger as one than we will ever be as many,” Racht said.

So, what makes that kind of change happen?

  1. Identify and engage all the key players necessary to create an integrated system of care. Every one of them.
  2. Acknowledge everyone is motivated by something; it’s just often not the same thing. However, just because everyone comes to the table for different reasons, doesn’t mean they don’t all have the same goal in mind.
  3. Change the culture of medical cynicism. SCA patients don’t all die anymore.
  4. Recognize that turf battles are deadly. We’re all here to save lives, so don’t argue about it.
  5. “The perfect is the enemy of the very good.” Pay attention to the details but don’t get lost in them. And educate the public that it’s better to do something than nothing at all.
  6. Capitalize on emotions. Use survival stories to motivate and inspire.
  7. Capture attention in unique ways, such as this PSA from the American Heart Association, or this one from the Heart and Stroke Foundation of Canada.

Also during Wednesday’s opening ceremonies, the winners of the 2012 National EMS Awards of Excellence were recognized for their outstanding achievements. Those winners include:

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