Arizona Resuscitation Academy Integrates Emergency Medical Providers into a System of Care

More than 200 participants joined national and international faculty in January for the annual Arizona Resuscitation Academy, a conference and training event aimed at maximizing survival from sudden cardiac arrest (SCA) by implementing and measuring each link in the cardiac “Chain of Survival.” The Cardiac Resuscitation Academy is a novel strategy to train as many rescuers as possible in a system-wide approach to resuscitation. The model was first pioneered in King County, WA and then promulgated through many states including Arizona through the Heart Rescue Program.

A basic theme motivates the academy: every cardiac arrest victim needs (and deserves) immediate bystander CPR, high-quality EMS resuscitation and guideline-based post-arrest care. Furthermore, this process must be continuously measured and improved. It is only by this iterative strategy that communities can save as many lives as possible from SCA, a leading cause of death in the U.S.

Several survivors shared their stories at the event, which was held at the Mesa Public Safety Training Facility. All had this in common—lay rescuers performed bystander CPR to initiate the seamless system of response that brought each victim back to life. 

“These are the great success stories,” said Dr. Ben Bobrow, EMS Medical Director at the Arizona Department of Health Services, which hosted the event in conjunction with the American Heart Association. “Each received early and continuous bystander compressions, high-quality EMS care and swift transport to recognized cardiac receiving centers. These folks, along with the more than 1,500 other survivors we now have in Arizona from the past decade, are proof that the system of care approach is the best strategy to save lives from cardiac arrest.”

The academy was designed to target three separate but equally important aspects of cardiac resuscitation and was led by several world-renowned leaders in resuscitation science: Helge Myklebust and Tonje Birkenes of Laerdal Medical Research; Katarina Bohm of the Karolinska Institute in Stockholm, Sweden; Dr. Christopher Crowe of Maricopa Medical Center; Dr. Dan Spaite of the Arizona Emergency Medicine Research Center; and Drs. Benjamin Abella and David Gaieski from the University of Pennsylvania.

The individual tracks—one for telephone-assisted CPR, one for EMS responders and one for hospitals aiming to optimize temperature management in post-arrest and resuscitation care—were a blend of lectures and breakout, hands-on skills sessions.

The telephone-CPR track covered the first-link essentials: how to recognize potential cardiac arrests over the phone, how to get type-appropriate CPR instructions started as early in the calls as possible and how to provide effective continuous coaching to lay rescuers after they’ve started CPR. Two themes emerged: that dispatchers must (1) take the lead and be assertive in directing lay rescuers to start CPR and (2) must provide clear, focused instructions to create and maintain high-quality compressions until EMTs arrive and take over.

“The Academy is important because it gathered more than 200 people who were truly interested in best practice and how to save more lives,” said Myklebust. “They brought home ideas and inspiration within dispatch-assisted CPR, EMS and hospital care. This holistic approach is probably the best way to strengthen the ‘Chain of Survival.’”

A highlight in the EMS track was a demo of high-quality CPR by crews from the Mesa Fire & Medical Department and Guardian Medical Transport from Flagstaff, AZ. These well-trained teams demonstrated the four-person pit crew model of resuscitation from the initial moments of being on-scene to patient transport. The teams showed how they implemented the latest CPR quality guidelines aimed at measuring and achieving high-quality CPR. They also showed how they are utilizing real-time audiovisual CPR feedback, simulation training and debriefing sessions for CPR quality improvement.  Additional demonstrations were shown on how to optimally transition to mechanical CPR devices with as little interruption in CPR as possible. These teams confirmed the importance of paying close attention to all monitor feedback and adjusting accordingly, as well as the importance of having a lead “choreographer” or team captain. 

Dr. Abella and his team from Penn led the hospital track with a condensed version of their popular two-day course, Hypothermia and Resuscitation Training Institute at Penn (HART). The course is designed as a “boot camp” to educate care providers on the use of targeted temperature management in post-arrest and resuscitation care. Dr. Abella, Ms. Gail Delfin, RN, and Dr. Gaieski presented topics that allowed attendees to explore the various methods and protocols currently being used around the country.

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Micah Panczyk is 9-1-1 CPR Program Manager at the Arizona Department of Health Services. A former newspaper reporter and editor, he holds two master’s degrees and lives in Phoenix, AZ.