Sudden cardiac arrest is one of the leading causes of death in the United States. Since cardiac emergencies are the most time sensitive of all medical emergencies, intervention cannot wait for EMS to arrive if we ever hope to make a dent in those prehospital deaths. I propose the time has come for EMS to expand its mission to include community outreach programs to help train the people we serve to in turn help us do our job better.
But community outreach should not just begin and end with cardiac arrest and CPR. According to the United States Labor Department’s Bureau of Labor Statistics, there were 3.1 million workplace injuries and illnesses in 2011. Most of these injuries and illnesses were not life threatening, although a small subset were. Of course, industrial sites have more potential for injuries than an office setting. But disease and illness are equal opportunity employers. They can and do happen everywhere. Statistically, most heart attacks occur on Monday mornings. And where are most people on Monday mornings? At work!
A few years back I started marketing the concept of creating in-house emergency response teams (ERTs) to businesses in our first due response area. For a mere $50 per person, we at Bucks County Rescue Squad offered to train and certify their employees in first aid and CPR. I pointed that, if they trained a few employees on each shift at each location or building, they would have personnel trained to handle the first critical minutes of any medical emergency before EMS arrives. I also pointed to the undeniable fact that there are two kinds of businesses: those which have already experienced a medical emergency and those which will. So, for $200–$300 on average, any business could have peace of mind and an action plan to handle whatever problems that may come their way.
Unfortunately, we did not have as many businesses take us up on our offer as I would have preferred, but those that did really took it to heart. One chemical manufacturing company opted to have all of its employees trained in first aid and CPR. Another company in the garage door installation and maintenance business opted to have all of its field personnel who operate service vehicles go through the training. And another company in the lighting manufacturing business not only had several of its employees trained, but bought responder first aid kits and set up an in-house activation system. If a medical emergency occurred anywhere in their plant, employees were instructed to call the receptionist, who would in turn activate their ERT by announcing the location and type of emergency via the overhead public address system.
In checking back with these companies one year later, most of the trained personnel had at least one occasion to utilize their training.
The EMS crews who responded to medical emergencies at these pre-trained locations had nothing but praise for these in-house emergency responders and, in a few cases, were surprised at just how much, and how well, they did.
We at Bucks County Rescue Squad use the American Heart Association’s Heartsaver First Aid Course for our first aid training. As an experienced EMS provider, an EMS instructor and especially as the quality coordinator, I believe the Heartsaver First Aid Course is excellent.
I recall the first time I took first aid as a cub scout. We spent four weeks going over some splinting and a whole lot of elaborate bandaging and knots that no one would ever be able to remember the next day, much less under the duress and stress of a real medical emergency.
The Heartsaver First Aid Course covers virtually every type of medical emergency you could possibly encounter, and it keeps it simple and focuses on doing the first, most important things to manage the emergency.
EMS has never been better trained or equipped than we are today. But for time sensitive emergencies, such as cardiac arrest, where brain death begins after just four to six minutes, or a severe hemorrhage, where the patient can bleed to death in just a few short minutes, treatment cannot wait for EMS. Even if the ideal national standard response time for EMS of fewer than nine minutes is met, it’s still not good enough in these cases and others.
Fortunately, the most critical medical emergencies are rare, but they do happen. Even in those cases where the emergency is serious but not immediately life threatening, it’s a generally accepted principle that the sooner trained medical care can be initiated, the better the outcome will be for the patient.
For a paltry sum of a few hundred dollars, any business can better prepare itself for the inevitable medical emergencies. And since almost everyone will need emergency medical care at some point in their lives, the owners and managers of these businesses should realize that the life they save by establishing an in-house emergency response team could well be their own.
Joe Hayes, NREMT-P, is deputy chief of the Bucks County Rescue Squad in Bristol, PA, and a staff medic at Central Bucks Ambulance in Doylestown. He is the quality improvement coordinator for both of these midsize third-service agencies in northeastern Pennsylvania. He has 30 years' experience in EMS. Contact Joe at firstname.lastname@example.org.