If you're going to have a heart attack or cardiac arrest, you might want to have it in the city of Wilmington.
The Wilmington Fire Department, in conjunction with New Hanover Regional EMS, has adopted a rotation-style of CPR that's saving more lives in our area.
The system started in Seattle and was incorporated into the WFD's program in April of 2011.
At the time, the "save-rate" of cardiac arrests in the City was about 9.6 percent. After the rotation-style CPR became the standard, the rate shot up to 19 percent in 2013. As of 2014, their save-rate stands at 24 percent.
"The old way of doing CPR in the Wilmington Fire Department was usually that the youngest man on the truck would do compressions," Scott Rivenbark explained.
Rivenbark is a Master Firefighter and an EMS Liaison.
"You'd be dripping sweat doing chest compressions for 30 or 40 minutes and never stop," Rivenbark said. "The youngest guy was dying. He was exhausted trying to make your heart beat 100 times a minute by pressing on your chest."
When a firefighter begins to fatigue the quality of chest compressions decreases. Without proper compressions, survival of the patient is at risk.
"We named it the 'pit crew process' because basically, you are in the South and we like NASCAR!" Rivenbark joked. "Like the pit crews on a NASCAR team everybody already knows what job they are going to do when they come across the wall. Same way when we get off the fire truck, we already know what we are going to do. Everyone is assigned to a job. There is no delay of care or delay of compressions which is the most important part."
As Rivenbark explains, maintaining circulation is the key to survival.
"If the blood is not moving the oxygen is not going anywhere," Rivenbark said. "You can breathe in and out of somebody all you want, but if the blood's not moving it's not doing anything."
When first responders arrive they check for responsiveness, pulse and breathing. If there is no pulse, chest compressions begin immediately.
"So one of the three guys, he's already been assigned chest compressions so he knows he just needs to start compressions," Rivenbark explained. "He's not going to do anything for two minutes but compressions. He has no other job."
The responder orchestrating the CPR is the one with the AED in hand. He or she must get the clothing off the patient as fast as possible so effective compressions and shocks can begin.
Another responder is giving oxygen with a bag.
After two minutes the AED analyzes the patient for a heartbeat. During this time the responders rotate.
"The guy who was just doing compressions is going to switch with the guy who was just doing airway," Rivenbark said. "The guy doing airway will switch with the guy doing AED. Whoever is doing the AED is actually taking a two minute break because they're next to do two minutes of compressions."
With this system, the quality of compressions is maintained and the effectiveness of the compressions is preserved.
"After we implemented pit crew, the first call we went on after we actually used pit crew, it was obvious afterwards that we weren't as tired." Rivenbark said.
Now, instead of measuring patients who get a heartbeat back and then are transported, the WFD measures those who get to the hospital, get well and then go home.
"Those are the only ones who count as a 'save' for us now," Rivenbark said.
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