It is always worthwhile to look around at what others in the cardiac advocacy realm are doing towards solving our common problem: how to address the cruel 3-6 minute limitation on SCA rescues? Often we find reiteration and validation of what we are doing ourselves, which is a good thing, but sometimes we come across some relatively novel and promising concepts.
Anton Gorgels of Maastricht University Medical Center in the Netherlands brings a European viewpoint onto this matter with his presentation via the European Society of Cardiology (2009). In it we find two valuable ideas not heard often enough in North America.
1) Resuscitation Networks
These are networks of lay people who have CPR/AED training, who agree to be contacted to assist during an SCA event within their nearby community. Like Tandem AED/EMS , which places AEDs in high rises to bisect and bridge the time required for EMS to arrive, these networks can enhance a victim’s chances in a number of ways.
a) They can speed the transport of a community-shared AED to the victim’s side, by someone closer to it. European AEDs are increasingly located outside to protect neighbourhoods.
b) They provide an extra trained person to perform CPR compressions while the AED is being brought, who can also speak with the EMS dispatcher, and take over from aged or juvenile assisting bystanders. They may also witness and confirm an SCA as it progresses.
These volunteers are alerted via their cell phones by text messages from the dispatchers. In North America ElevAED has developed AED enclosures that themselves dial out with text messages to up to ten different numbers; in that scenario onsite AEDs are communicating with volunteers within the same building complex. ElevAED also has devices that allow tower residents to dial out the same way from a pendant or wristband – useful in many emergencies.
The take-away from these resuscitation networks is that they are pre-hospital and pre-EMS solutions to shortening the response time. They establish beyond any doubt that the task of defeating the tight constraints of SCA’s is increasingly going to be led by assisting volunteers and localized AEDs, not by escalating expectations of, or demands on, overstretched EMS resources.
2) VF detection and alarm
In this approach a sensor continuously monitors vital signs, whether it is implanted or attached to the skin, or carried separately. (Editor’s note: ElevAED believes a button pendant is the most practical option here, but for its people powers, not its technology. Your loved ones, neighbors and co-workers care more than call centers…)
At the onset of an event it generates a local alarm, and at the same time alerts EMS dispatchers, with its position and that of the nearest AED. Again, this is infrastructure out in the field that sets the stage for early defibrillation. By whatever route, such alerts are precisely what the Next Generation 9-1-1 Cloud model is designed to promote.
In the race to treat SCA victims, these volunteer networks and dedicated devices promise significant progress, if implemented, toward compressing response times down to the required few minutes, within which the rescue success rate skyrockets.
Diagrams/graphics courtesy of Anton Gorgels and the European Society of Cardiology.