Cardiac Arrest in Cottage Country

When you go into cardiac arrest it is almost assuredly your day to die. Survival rates for out-of-hospital cardiac arrest have historically been dismal, less than 4% in most communities. Over the past decade there has been a measurable improvement with select North American cities now reporting survival rates in excess of 15% and even as high 20%. Improved survival rates can only be achieved by implementing programs that decrease the time from patient collapse to the first shock with a defibrillator.

Studies have reported survival rates for defined locations (airports, casinos, schools) as high as 75% when the first shock is delivered within 3 minutes of patient collapse and 50% at the 6 minute mark. Survival is possible up to the 12 minute mark but very unlikely beyond that time. Recognizing this reality the Ministry of Health and Long-term Care in the Province of Ontario now requires all Ambulance Services to submit a response time plan that includes a percentile target for responding to Sudden Cardiac Arrest in 6 minutes. Below is a list of the targets submitted by the three largest cottage country Ambulance Services.

http://www.health.gov.on.ca/english/public/program/ehs/land/responsetime.html

The New (2012) Ontario Ambulance Response Time Standard

• Muskoka - The target is 8 minutes 75% of the time
• Actual 2011 response times for SCA - 6 minutes 25% of the time
• Haliburton - The target is 6 minutes 33% of the time
• Kawartha - The target is 6 minutes 45% of the time

Note: These times do not include the time from patient collapse to EMS notification and time from EMS arrival on scene to the delivery of the first shock.

The fact is most cottages will not experience 6 minute response times. This is not an indictment of local EMS, it is simply a reality, an intentional reality – we love our cottages because they are remote.

If you do not have an Automated External Defibrillator (AED) at your cottage anyone that goes into cardiac arrest on your property will in all likelihood die. The gift of life, an AED plus appropriate training including CPR, for friends and family, can be acquired for less than $2,000 all in. The training also includes a discussion on recognizing and managing Heart Attack and Stroke , two additional time sensitive cardiovascular emergencies which typically have poor outcomes when they occur at the cottage.

Think of all the ways you could spend two grand on your cottage and what the benefits of that purchase will be. To learn more about protecting the lives of family and friends at your cottage please contact me.

 

Leading Cause Prevention Strategies

Blake Hurst

29 Mericourt Rd.

Hamilton ON

L8S 2N5

 

905 527-0462

905 978-1023 cell

 

blake.hurst@cogeco.ca

www.leadingcause.ca

 

 

 

The First Commandment of Resuscitation

The First and Great Commandment of Resuscitation -

Thou Shalt not have a Favourite Link in the "Chain of Survival"

 

It is called a chain because every link is critical. No one who truly understands how resuscitation works would lobby government for funding or policies to strengthen just one link in the chain. We need to build comprehensive community cardiac response programs that address and strengthen every link. I read an online debate from British Columbia this week arguing the merits of legislating mandatory CPR training versus mandatory AED placement. There is no question of "or" the only correct answer is "and".

In Ontario we have a physician group lobbying for mandatory CPR and I marvel at their naivety. In Manitoba they are hanging AED's all over the province with no mandatory training requirement, setting up a future filled with lost opportunities to save a life. The evidence is clear and unequivocal every link in the chain makes a significant contribution to improving survival rates for out-of-hospital cardiac arrest. Bystanders must quickly recognize the situation and spring into action, quality CPR must be started immediately, an AED must be applied soon after, EMS must get to the patients side quickly, ER physicians must cool the patient and the patient must take ownership of his/her rehabilitation. If you are engaged in advocacy to improve outcomes for cardiovascular emergencies in your community you must, must, must advocate for strengthening every link in the chain, not just your pet link.

Every cardiac arrest patient needs several things to go right if they are to survive neurologically intact to discharge. After reviewing tens of thousands of cardiac arrest data sets resuscitation researchers have proven beyond a shadow of a doubt that multiple inputs are required to achieve good outcomes.

We live in an evidence based world. Respect the evidence.