Arkansas' largest ambulance service says cardiac patients' survival up since priority on CPR

MEMS lists aid at scene as vital

Arkansas' largest ambulance service reported that the number of patients it revives from cardiac arrest has continued to rise since the agency changed its treatment protocol last year.

Metropolitan Emergency Medical Services of Little Rock began performing uninterrupted CPR at the scene of cardiac arrest calls beginning Nov. 23, 2015, a measure that medical experts say provides a greater chance of survival. The agency treats cardiac arrest patients on a case-by-case basis, but under its new guidelines, extended on-scene treatment is preferred over quick transport to a hospital.

In the months since MEMS adopted those guidelines, the number of patients revived from cardiac arrest increased from roughly 15 percent to about 32 percent, according to agency officials.

This month, after one year under the new protocol, that figure reportedly increased to more than 35 percent.

"The key is staying where you are," MEMS quality assurance manager Mack Hutchison said. "If you're trying to move somebody to a cot or an ambulance, you can't do quality [chest] compressions."

Cardiac arrest is the abrupt loss of heart function caused by malfunctioning electrical impulses. It's the third-leading cause of death in America behind heart disease and cancer, according to the National Academies of Medicine. About 600,000 people per year are affected by cardiac arrest.

MEMS is among many emergency medical services that now emphasize extended CPR instead of quick transport for cardiac arrest patients. Ambulance services in North Carolina, Maine and Arizona have reported similar increases in the number of patients revived, with many agencies in recent years reporting survival rates around 40 percent.

MEMS, a nonprofit agency that serves more than 530,000 residents in Pulaski, Faulkner, Grant and Lonoke counties, responds to roughly 700 cardiac arrest calls annually.

Becky Iverson of Maumelle credited the agency's new treatment protocol with saving her husband's life in July.

She said her husband, Dean, 70, was playing golf when his chest began to hurt. The pain was odd because he had no history of heart disease -- a common factor in cardiac arrest cases -- and had no other serious health problems. But he soon stopped breathing, and she called 911.

A dispatcher instructed Becky Iverson to perform CPR.

"Two compressions a second, 2 inches deep," she said. "He kept telling me that over and over."

The Maumelle Fire Department and MEMS medics soon arrived and continued to perform CPR on him. The emergency crews took turns treating him, uninterrupted, for more than 20 minutes and then transported him to a hospital.

Dean Iverson lived.

"Starting CPR immediately was probably key in his survival," Becky Iverson said.

Though MEMS and other emergency medical services have increased the number of patients revived from cardiac arrest, the overall survival rate remains low. Less then 6 percent of those who suffer cardiac arrest outside a hospital survive, according to the Academies of Medicine.

Those who do survive can suffer brain damage if treatment isn't fast.

With that in mind, MEMS Executive Director Jon Swanson said the agency has offered free CPR training to businesses, church groups and other organizations since spring. He said in cases of cardiac arrest, friends, co-workers and family members are typically the first link in the "chain of survival."

Swanson said bystanders who perform CPR before medics arrive can increase the chances of a person being revived. That, in turn, can increase the chance of survival.

"This is where the public and their willingness in being able to identify and perform CPR comes in," he said.

Swanson noted that CPR is strenuous when performed correctly, and it's not uncommon for several bystanders and medics to take turns treating a patient. Other ambulance services have called it the "pit crew" approach.

MEMS medical director Dr. Charles Mason said the length of on-scene CPR treatment varies from patient to patient. He said in some cases, medics perform CPR for more than an hour before a person's cardiac activity returns.

Mason said the agency is also working to improve its cardiac arrest treatment through technology. The ambulance service's roughly 220 uniformed personnel were training to use devices that monitor the carbon dioxide concentration in a patient's breath. Mason said that information tells medics when it's appropriate to provide oxygen to a patient, and it provides clues to several physiological processes.

"If you're doing a good job with your compressions, you'll have a certain level on your [carbon dioxide monitor]," he said.

MEMS officials said the agency has a long-term goal of reviving 50 percent of its cardiac arrest patients every year, which would be one of the highest rates in the country.

They said they're hoping for more cases like Dean Iverson's.

His wife said this month that doctors had implanted a pacemaker in her husband's chest, he'd completed rehabilitation and was "doing fantastic."

"They're just amazed that he lived, and he's doing so well," she said.

Metro on 12/25/2016

Upcoming Events