CPR courses break down into two components, management of the unresponsive patient and management of the conscious patient. When CPR training is being bought and sold the emphasis always seems to be on the value of the unresponsive patient portion of the training; performing chest compressions and applying an AED to cardiac arrest victims. The value proposition that both buyers and sellers tend to focus on is how many people are likely to go into cardiac arrest at a location that we are responsible for and how can we insure that the organization is prepared to respond to that event with the minimum investment in training and equipment?
People that buy CPR for, or are selling CPR to; a corporation, a municipal, provincial, state or federal government, a school board or a private, provincial or state health care delivery system should apply equal or greater weight to the value of having as many people as possible properly trained to recognize and manage the conscious MI or Stroke patient. Recognizing and responding to MI and Stroke in a timely manner in the pre-hospital setting is the singular way to achieve the best possible outcome for these potentially devastating events.
Advancements in the treatment of MI and Stroke, when therapy is initiated within 90 minutes of the onset of symptoms, are producing amazing, life changing results. Patients who previously would have been left completely debilitated for months or even longer are now leaving hospital in days and returning to a quality life which often includes a return to work within a few weeks. Anecdotally we hear of construction workers and firefighters returning to work six to eight weeks after a STEMI. More importantly the published data is unequivocal in pointing to "time" as a leading contributor to good outcomes.
MI and Stroke rehab is often a long and costly process. The cost burden falls to employers and to the health care system. In a jurisdiction such as Ontario (pop. 12 mill.) the price tag for cardiac and stroke rehab runs into the hundreds of millions each year. That does not even begin to consider the hidden costs that the healing process takes on individuals, families and employers. It would require relatively few instances of an early 9-1-1 call resulting in a best possible outcome to produce a positive return on money invested in quality CPR training.
Excellent recognition and mangement of MI and Stroke symptoms by witnesses in a pre-hospital setting has the potential to produce significant overall cost savings for all stakeholders. If your job places you under pressure to reduce the skyrocketing cost of healthcare delivery you need to be considering an investment in broad based CPR training with a strong emphasis on MI and Stroke recognition and management
Hospitals, Ambulance Services and CPR Training Agencies need to work together to develop MI and Stroke messaging for the community. Adult learners take great comfort and assurance in knowing that local Physicians have contributed to the curriculum. It helps older adults to understand why they or their spouse will not be taken to "their" hospital, but rather to the regional MI or Stroke Centre. Buyers need to insist that all CPR training features a strong MI and Stroke management component that includes an up to date review of local protocols. Sellers need to be promoting the benefits to both the client and the community of improved MI and Stroke pre-hospital response.
As you are reading this blog an individual, couple or group within close proximity to you are observing a family member, colleague or friend experiencing MI or Stroke symptoms. None of them want to pick up the phone because they are all unsure of what should be done. When the Paramedics arrive and ask the question "When is the last time you saw the patient in a normal state of health?" and the answer is "Oh she's been like this for about three hours now" it will be too late....and the funds for a long and expensive rehab program will need to be found.
Resuscitation (bringing dead people back to life) is dead sexy, but use your money to buy some steak along with the sizzle.
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