Note: This interview originally appeared in Oct. 2018. EMS World is republishing the article on the occasion of NHTSA's recent release of CPR LifeLinks. To download the CPR LifeLinks ImplementationToolkit, visit ems.gov or 911.gov.
The National Highway Traffic Safety Association (NHTSA) is currently asking for stakeholder input on a how-to guide for EMS and 9-1-1 agencies to implement programs that improve telecommunicator and high-performance CPR. “CPR LifeLinks” is a national initiative to help communities save lives of those who suffer sudden cardiac arrest (SCA).
The project came out of a report released in 2015 by the National Academies called “Strategies to Improve Cardiac Arrest Survival: A Time to Act,” which analyzes the “complete system of response to cardiac arrest in the U.S. and identifies opportunities to increase survival."
Bentley Bobrow, MD, FACEP, FAHA, is professor of emergency medicine at the University of Arizona College of Medicine and project lead for the CPR LifeLinks Implementation Toolkit.
Micah Panczyk is Cardiac Resuscitation Program coordinator at the Arizona Emergency Medicine Research Center at the University of Arizona College of Medicine–Phoenix. His work has focused mainly on telephone CPR quality improvement programming. He has co-authored more than a dozen papers and articles on the subject and has been a faculty member at resuscitation courses across the United States, Europe and Asia.
EMS World: What does the training look like? How will users/educators experience the training?
Panczyk: The LifeLinks project goes beyond standard training and employs real-world scenarios in as realistic a manner as possible to build provider confidence and proficiency. The training is both cognitive and hands-on practice with not only single providers but in the case of high performance CPR, with teams. The training has standard printable and presentation materials but also has links to examples of useful training videos. The core slides serve as a foundation for training and will direct users to more detailed information in the NHTSA toolkit.
We know that high performance CPR and TCPR are critical to the chain of survival—how do you propose that PSAP personnel and EMS personnel train together?
Bobrow: The foundation of CPR LifeLinks really is this collaboration between 9-1-1 and EMS, which can improve the quality and continuity of care for all time-critical medical conditions. Training around CPR is one very functional way for 9-1-1 centers and EMS agencies to begin building a relationship that then fosters data sharing, collective process and patient outcome measurement and ongoing quality improvement. For example, EMS trainers can teach 9-1-1 telecommunicators the nuances of CPR performance and some of the clinical aspects of the event that help them understand the situation and deliver more effective instructions. Telecommunicators can reciprocate by informing EMS rescuers about the real-world challenges of identifying cardiac arrest over the phone and engaging and calming callers to perform CPR when necessary.
What are some of the hurdles of this type of training?
Panczyk: For some communities, the two components of public safety are not yet fully integrated so the first hurdle is coming together to understand how they are both the key to improving cardiac arrest care and outcomes in their community. There are other challenges commonly faced such as scope of practice, staffing, resources, etc. These are all addressed in the CPR LifeLinks Project with real-world examples of how to overcome and succeed at saving lives in any community.
How will you measure Life Links’ effectiveness?
Bobrow: This is our ultimate goal. We can surely measure the uptake and utilization of the CPR LifeLinks tools but we hope to go way beyond that and measure patient outcomes in communities (for example, using the CARES registry) that adopt, implement and measure CPR LifeLinks.
What is the timeframe for the project’s release?
Bobrow: Public comment phase will end October 1. We will then carefully review the input received, which we anticipate will further refine and enhance CPR LifeLinks. That phase will take as long as necessary to get the project ready for formal release. Our goal is sometime in early 2019 and optimally sooner. People are anxious to get started saving lives!