Hoping to resuscitate people stricken with cardiac arrest, state health officials have tweaked what happens when you dial 911. Last year, the Arizona Department of Health Services rolled out new training for emergency-call dispatchers to help recognize the signs of cardiac arrest and coach bystanders to begin a new style of CPR. Ben Bobrow, medical director of the department’s Bureau of Emergency Medical Services and Trauma System, said the program is the latest step in a years-long effort to boost the survival rate of those who suffer cardiac arrest.
There are 380,000 cases of sudden cardiac arrest every year nationwide and an average of 15 a day in Arizona. Nationally, the survival rate is 5 to 8 percent. While a state program implemented in 2004 has improved Arizona’s survival rate to 32 percent, the latest effort is meant to move the rate higher. The new dispatcher training, consisting of in-person classes and online tutorials, emphasizes asking fewer, more-specific questions to verify cardiac arrest and encouraging callers to begin cardiopulmonary resuscitation.
Bobrow said the goal is to begin resuscitation in less than a minute after a call comes in, as a victim’s chance of survival drops 10 percent for every minute he or she doesn’t receive help. Since the majority of cardiac arrests happen at home, friends and family are key to keeping the patient alive. “The danger is not doing CPR wrong or on someone who doesn’t need it. The danger is doing nothing,” Bobrow said. Bystanders are asked to start chest-compressions-only CPR, instead of the traditional form, which mixes compressions with breathing into the patient’s mouth. Bobrow said the new program eliminates unnecessary dispatch questions and encourages people who don’t feel comfortable performing traditional CPR. “These really subtle things make the difference between starting CPR or not, and that means life or death,” Bobrow said.
Data is still being collected, but Bobrow estimates that dozens of lives in Arizona have been saved by the program. Some dispatch centers have decreased the time from a call to the start of CPR by 50 percent, with the average now two minutes, he said. Doreen Wasick, the lead dispatcher at the Mesa Regional Dispatch Center, said the center’s average time from receiving a call to starting CPR has dropped by a minute since it implemented the new system in November.
The focus on chest compressions has also hastened care. With the old CPR, chest compressions often hadn’t started by the time the paramedics arrived, she said. “It’s so nice we can do what will help until the paramedics arrive,” Wasick said. For the first month under the program, Mesa recorded eight lives saved. Wasick said her center’s goal is to save 75 percent of cardiac-arrest patients.
Chris Stringfellow, an emergency dispatcher with Rural/Metro Fire Department, which covers communities in Maricopa, Pima, Pinal and Yuma counties, said he’s seen the program help keep people alive three times in the past three weeks. Jeff Jennings, a supervisor at the Sedona Fire District’s Regional Communications Center, said his department has been doing a similar phone-assisted CPR program for 20 years.
Because of the department’s rural setting — it covers 11 communities in the Verde Valley — such a program is necessary to keep people alive, he said. “It takes Phoenix four to five minutes to get on a scene. It takes us six to eight minutes on a good day,” Jennings said.
The dispatcher-assisted CPR campaign is just a portion of the health department’s ongoing effort to decrease the number of cardiac-arrest fatalities. The Save Hearts in Arizona Registry and Education, or SHARE, program was implemented in 2004 after the department realized Arizona had a sudden-cardiac-arrest survival rate of 3 percent.
The program seeks to encourage bystander response and standardize emergency-responder and hospital treatment through information campaigns and training. More than 900 lives have been saved through the SHARE program since 2004.