There’s a lot of art in prehospital medicine, but the response to a cardiac arrest is mostly science. You can break down its components and use hard numbers to describe intervals and performances where we know numbers matter.
That’s how Medic One’s operation in northeastern King Co., WA, part of the Redmond Fire Department, is using its Code-Stat data-review software from Physio-Control.
Crunching data from the company’s Lifepak 15 monitor/defibrillators, Code-Stat enables near-instant breakdown and review of individual responses, and the easy collection of performance data in aggregate. It recreates calls with waveform playback and allows addition of notes, photos and annotations. Redmond’s Medic One uses it to break down individual cardiac arrest performances and rapidly review them with paramedics for immediate quality improvement.
“Our Lifepaks auto-populate the data to our servers, so our annotators can open up Code-Stat and start annotating very soon after an arrest happens,” says Dana Yost, a senior paramedic who administers the program. “Then the crews can come back and get instant feedback, both raw data from their case before it’s annotated and thereafter by having it annotated, and can get a progress report that tells them how well they did on that particular arrest.”
That’s important, because weeks later, Joe Paramedic isn’t going to remember details like what caused a particular interruption in chest compressions. But with feedback so quickly, he could be doing better CPR 10 minutes from now.
To gauge the potential benefits of this approach, consider CPR fraction times. Three years ago, Redmond Medic One’s was 66%. Now it’s regularly exceeding 90%.
“The take-home message is, if you don’t collect data, you have no idea where you are,” says Yost. “Until you start collecting and analyzing data and giving feedback, you won’t see a significant change. The average CPR fraction time across the country is 40%, and we wonder why resuscitation rates are low. They need to be higher, and they can be, with a little hard work and attention to detail.”