The cellular revolution has provided us with the tools to greatly improve survival from medical crises in large facilities, which are otherwise just plain dangerous to live and work in. The damage and deaths that result from over-dependence on vehicular EMS is now unconscionable, and it is time to preserve lives and resources with a more rational and directed approach.
The sky’s the limit for high rise construction it seems, around the world. They are tall, graceful, and of course green. But they have one dirty little secret, which is about to be cleaned up.
The New York Times continues its excellent advocacy of Naloxone vs the expanding opioid pandemic.
Frequently asked questions about Narcan/Naloxone, an anti-opioid for heroin, morphine, vicodin, oxycontin etc.
“A simple syringe with a dose of naloxone should cost about $3 …but experts expect that Evzio could well be priced close to $500.”
Elevaed’s LifePad™ and Tandem AED/EMS for rescues in building complexes can reclaim these “no-survivor” zones for heart, stroke and overdose “events”. Survival could increase by a factor of ten!
As overdose deaths surge, the existence of an antidote as effective as Naloxone is making itself evident. Too bad the medical associations can’t show more leadership on this critical issue.
The FDA approved the equivalent of an “epi-pen” for overdose prevention, an antidote auto-injector that even untrained people can use to save the lives of those who have overdosed on drugs like Vicodin or heroin.
The availability of naloxone/narcan as a nasal spray holds much promise for its wider deployment.
“It makes sense to focus attention on the most dangerous types of drugs.”
For too many, ‘protection’ by the government leads to their needless death.
With “deaths from narcotic painkillers, or opioids, quadrupling since 1999″ wider distribution of Narcan (anti-opioid) is critical.
Naloxone is a benign drug that CPR volunteers could use to rescue overdose victims, who now outnumber auto fatalities.
The Tandem AED/EMS strategy has an in-house AED delivering its lifesaving treatment well within four minutes. EMS then arrives some minutes later to consolidate the rescue.
Two studies have found that high rise buildings add 2.7 minutes to medical emergency responses, which means that from an event’s onset it takes about 13 minutes to get alongside the patient. The life safety protocol can close that to 3 minutes with security-based EMR’s.
Medical protocols exist so that quality care can be delivered reliably. We now have to hand the ball to our public health administrators to allow such basic strategies to take hold and enable change.
“50 largest cities save only an estimated 6% to 10% of the victims of sudden cardiac arrest who realistically could be saved.”
The scary thing is nobody thought of onsite responders, even in monster Dubai high rises. And they try to convince everyone (except the pros) that 15 min responses are OK. The public needs to be told.
Total reliance on EMS vehicles is not necessary in high rises, where onsite resources and responders can meet early intervention goals reliably.
OK, they can do no more, when AEDs have a 4 min limit – understandable. On behalf of the 95% who die – might we try something new, something onsite?
Adding two minutes to the “8:59 standard” leaves a trail of dead and brain damaged victims everywhere. But in high rises, which already take an estimated 2 more minutes to access, they had may as well ask the coroner to saddle up the horses and roll the morgue wagon one more time.
Dispatchers obviously need more autonomy, and less data entry, before sending.
Rusinek’s life ticked away on the corner where she fell. Twelve minutes passed before an ambulance crew connected a defibrillator to her chest.
The famous article from the NYT in 2002, which nailed the problem, and a dozen years later – little progress. Clearly, onsite first responders are the premium solution for cardiac protection in complexes. And for OD’s too.
AED overkill is expensive and presents educational issues (even in a university) when multiple brands are involved…
The NFPA and IFC both rejected Elevaed’s proposals to place AEDs in high rises. EMS is a closed shop, and will not admit that they very rarely get to victims in high rises under ten minutes, which is far too late. We will have to save ourselves, and pay them as well.
Here is the substantiation provided to the code examining committees.
Efforts to improve survival should focus on the prompt delivery of medical interventions. CPR and AEDs both need good neighbors.
Public-access defibrillation with AEDs is being implemented in many countries with considerable financial implications.
‘Medical creep’ happens when doctors perform procedures or prescribe treatments for patients in the absence of clear evidence that patients will benefit.
Given our overweight and aging boomer generation, expect heart safety to emerge as a welcome and affordable concept.
Common questions about AEDs and Public Access Defibrillation (PADs), with answers from the American Heart Association
This article demonstrates little awareness of the need to protect high-rises as homes or workplaces as well.
It doesn’t matter whether or not EMTs do a few minutes’ CPR before defibrillation of cardiac-arrest patients, researchers conclude.
The continuing study of adjunct treatments for SCA; see also CPAP and the recent doubts about epinephrine
Application of an AED in communities is associated with nearly a doubling of survival after out-of-hospital cardiac arrest.
Significant delays present when accessing patients in high-rise buildings and evacuating them to the hospital.
US National NEMSIS cardiac arrest elapsed patient care times as an average (table) and as a 90th Fractile (graph).
Pivotal 2005 study establishes no survival benefit from EMS arrival within 8 min – only if within 4 min.