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Friday, March 03, 2006

Cardiac Arrest

Cardiac Arrest

When a person suffers a cardiac arrest and falls to the ground, the person’s heart is usually not stopped, it is “fibrillating”. In other words, the lower chambers are beating so fast that they are not letting the heart fill and very little blood goes to the body.

The best way to convert this heart back to a normal beat is to shock (defibrillate) the heart as quickly as possible. For each minute that a heart is not shocked in this condition, there is a 10% chance that the patient will not make it. Medical personnel have been shocking people back to life for decades. It is the only single modality that has been too shown to save live lives in the prehospital setting.

More than 350,000 adult Americans die each year of sudden cardiac arrest. The event is unpredictable and can occur in patients with no history of cardiac disease or cardiac symptoms. The necessary response is rapid application of electrical shock.

In 1991, the Emergency Cardiac Care committee of the American Heart Association concluded that…”all emergency personnel should be trained and permitted to operate an appropirately maintained defibrillator, if their professional activities require that they respond to persons experiencing cardiac arrest.” AMT was shocking arrest victims; however, the PFD was unable to do this until they purchased their own defibrillators with the Foreign Firefighters Fund in 1996. Thus, they became a Basic-D unit. The Peoria Fired Department should have been permited to shock victims of caridac arrest for years and not have to wait for AMT to show up and administer the shock when the PFD was at the scene first.

Did the project medical director, Dr. Hevesy, ask the PFD to acquire these units? Did he talk to the City of Peoria to purchase these units for the PFD? Did he ever say or do anything to obstruct the PFD from becoming a defibrillation unit? Was he trying to protect AMT as being the only pre hospital service in Peoria that could shock the patient in a full cardiac arrest? What did Dr. Hevesy think about the AHA’s conclusion established in 1991 derived from research from the previous decade?

I took care of many cardiac arrest victims in the ER at OSF for 13 years. Many were brain dead. Were they shocked soon enough in Peoria?

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