Monthly Archives: February 2007

Wake EMS Uses New Tools During Cardiac Arrest

 

Continuing in it’s aggressive management of victims of cardiac arrest,the Wake County EMS System is using new tools to aid in resuscitation.

Vidacare's EZ-IO®

 

Vidacare’s EZ-IO® provides rapid vascular access during cardiac arrest or severe trauma.
Wake EMS was an early adopter of adult intraosseous routes for medication and fluid delivery. Using the battery powered handle the needle can be placed in a matter of seconds. No more searching for IV access in critical times.

With a coordinated team of firefighter first responders and County paramedics, Wake’s revival rates is one of the best in the Nation.

In addition to rapid vascular access, the Wake EMS System uses a device on the end of the endotracheal tube that maintains pressure in the cadio-pulmonary vascular bed aiding in cardiac blood flow.

The ResQPOD Circulatory Enhancer® from Advanced Circulatory Systems,INC.

ResQPOD Circulatory Enhancer®

is used in conjunction with uninterrupted CPR and continuous capnography.

 

[from the ACSI’s website] … Sudden cardiac arrest, traumatic injury, heat stroke and the common faint, for example, all result in states of low blood flow or perfusion. In each case, a lack of adequate blood flow back to the heart contributes to the low blood pressure. States of low blood flow impair the body’s circulatory function, which delivers oxygen to the body’s vital organs and removes toxic cellular waste.
ACSI’s circulatory enhancer technology uses inspiratory impedance to increase blood flow to the body’s vital organs. It is unique in that it enhances the body’s biophysical performance without depending upon pharmaceutical or other outside agents. This patented inspiratory impedance technology uses the relationship of the heart, lungs and thorax to increase venous blood return to the heart…

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Wake Government Information on Hypothermia

Official Wake County Government Site – Hypothermia Information

Induced Hypothermia

Every 18 hours, the Wake County EMS System responds to a patient in cardiac arrest.  These individuals have no pulse and no respiratory effort and will certainly not survive in the absence of intervention from the EMS providers.

The citizens of Wake County benefit from a well coordinated, evidence-based EMS response.  Victims of cardiac arrest in our community are among those with the greatest chance of survival.  In April of 2005, we modified our method of CPR delivery, eliminating the pauses in compressions associated with counting 15:2 or 5:1.  Since that time, we have noticed a 10% increase in the return of spontaneous circulation for victims of cardiac arrest in our community.

Despite this excellent level of care, over 75% of our cardiac arrest victims do not survive from the hospital neurologically intact.  In a large portion of these cases, we are resuscitating the heart but not the brain, leaving our patients in persistent vegetative states.

Beginning in May of this year, we evaluated data regarding controlled cooling, or induced hypothermia, for victims of cardiac arrest.  Representatives from Duke Health Raleigh Hospital, Rex Healthcare, and WakeMed Health and Hospitals joined the Wake EMS System in this evaluation process.  Over several months, we reviewed the American Heart Association guidelines, the studies from the literature, and practices from other communities.  As a result, we have developed a comprehensive, community-wide plan for care of victims of cardiac arrest.

The therapy is focused upon controlled cooling for patients who have return of pulse but are not neurologically intact — aka, remain in a coma.  While this is a new indication for induced hypothermia, it is important to note that induced hypothermia has been utilized for years.  Since the 1960s, this has been utilized in the operating room for patients undergoing open heart surgery.  More recently, it has been used for victims of heart attack and continues to be evaluated for future use in traumatic brain injury and stroke.
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