Date: Fri 20-Dec-1996

Publication: Bee

Author: KAAREN

Quick Words:

health-defibrillators-heart

Full Text:

Health w/photos : Emergency Services Work To Speed Aid To Heart Attack Victims

B Y K AAREN V ALENTA

It's 3 am. The caller, who lives on Maltbie Road, is frantic. Her husband got

out of bed and collapsed, an apparent heart attack victim.

It's 5:30 pm, the height of rush hour, when a 911 call alerts the emergency

dispatch center in Edmond Town Hall that a woman on Great Quarter Road is

feeling faint and having difficulty breathing.

The question in the minds of both victims' families is the same: How soon will

the ambulance arrive?

Timing is crucial, particularly in cardiac cases. If there is no pulse and and

the victim has stopped breathing, brain damage occurs within four to six

minutes unless CPR (cardio-pulmonary resuscitation) is started immediately.

"You have 10 minutes to get a defibrillator there," said Scott Arnold,

emergency medical services coordinator at Danbury Hospital. "After 10 minutes,

there is less than one percent odds the victim will survive. But if CPR

(cardio-pulmonary resuscitation) is started, and the defibrillator gets there

within 10 minutes, the survival odds increase to 40 percent."

In an effort to reduce response time, the Newtown Volunteer Ambulance Corps

and the town's five volunteer fire companies are joining forces to work

together in what could be a major change in the way that emergency medical

services are delivered. Volunteer firefighters from each of the companies

recently completed training as MRT's (medical response technicians) and have

been trained to use defibrillators, receiving dual certification.

"It's a major move - one that is very exciting," said Debbie Aubin, an

ambulance corps member who helped coordinate the training program. "The hope

is that each fire company eventually will have a defibrillator and also could

be a first responder."

In a town the size of Newtown, with the ambulance garage located on Mt

Pleasant Road and residents spread over 60 square miles, getting assistance to

victims quickly is a challenge that has required creative solutions.

"In Newtown, the entire ambulance corps is a first responder which means that

we send our EMT's directly to the scene while one of our members goes to pick

up the ambulance," said Ambulance Corps Chief Steve Rambone. "This way we can

get someone to the scene much more quickly and help can begin before the

ambulance gets there."

But the number of calls is steadily increasing while the corps membership

hasn't grown significantly over the past 20 years.

"We had 40 members and 500 calls in 1975," Chief Rambone said. "We're now

handling 1,200 calls a year with 48 members, and eight or nine of them are

trainees. In fact, our call volume is greater than all five fire companies

together."

As part of a continuing study, Chief Rambone made a pin map to locate the

sources of the calls with the idea that it might be helpful to house an

ambulance in another part of town.

"That's still a long-term possibility, particularly since parts of the town

are growing by leaps and bounds," he said. "But right now we would like to get

a few more defibrillators - we have one for each of the (three) ambulances -

to distribute directly to first responders in each part of town."

In July, three of the fire companies began to respond immediately, along with

the ambulance corps, to all motor vehicle accidents on I-84. It was about this

time that the corps learned that William Halstead, chief of the Sandy Hook

Volunteer Fire and Rescue Company, had been talking to emergency medical

services personnel at Danbury Hospital about getting MRT and defibrillator

certification for the members of his company.

"I think the ambulance people do an unbelievable job but we wanted to be

trained in case one of our (firefighters) got hurt - and we wanted to be able

to do more at motor vehicle accidents," Chief Halstead explained. "In the

past, our role generally has been limited to providing lifting assistance for

the ambulance (corps), helping at an MVA or driving the medic vehicle. By law,

we weren't able to help (a victim) at an MVA, we could only do an extrication.

With certification, we'd be able to start earlier or assist."

Working with Danbury Hospital and the American Red Cross, ambulance corps

members set up a 45-hour MRT training course for the firefighters and a

two-night defibrillator class. Natalie Dos Santos and Debbie Aubin, along with

Scott Arnold as lead instructor, conducted the Red Cross/MRT classes, which

met two evenings each week for 10 weeks, while Chris D'Esposito provided

training in the use of the defibrillators.

Approximately 20 firefighters, representing all five of the town's fire

companies, participated. There were 12 from Sandy Hook alone.

Debbie Aubin said that since the fire companies already are located in each

section of town, it would make sense to equip each with a defibrillator. But

before the firefighters also can serve as first responders, many legalities

must be worked out.

"We plan to have a meeting, sometime in January, at which representatives of

Danbury Hospital, the ambulance association, all five fire chiefs and maybe

representatives of the town government will all sit down to work out the

legalities and the liabilities," Scott Arnold said. "We have to determine how

it will work, decide who's responsible for what. Protocols and procedures have

to be written. And an application has to be filed with the state because under

the existing state regulations, Newtown ambulance is the (only) authorized

first responder."

The defibrillators, which range in cost from approximately $3,500 to $8,000,

are easy to learn to use. The newest computerized versions do all of the work,

determining whether victim's heart needs to be shocked to have a normal

heartbeat restored, and applying that shock as needed.

"Just like citizen CPR, all you need is to check for pulse and put the

(defibrillator) pads on the right place. It's not rocket science," Mr Arnold

said. "Already airlines are putting them on planes and they are being placed

in skyscrapers and shopping malls."

But timing is crucial - it's the foundation of the "chain of survival," Chris

D'Esposito said.

"Timing starts when the medical emergency occurs, not when someone calls 911.

You need a bystander or first responder to start CPR, then early

defibrillation," he said. From that point, medications and continual

reassessment of the patient's condition - all part of ALS (advanced life

service) - are needed until the ambulance reaches the hospital.

Many of the emergency services personnel in Newtown foresee a day when the

police also might be trained as first responders.

In some larger cities, such as Bristol, where Newtown Police Chief James

Lysaght previously worked, police officers are certfied as MRTs. In some

states they even have defibrillators in their cruisers.

"I see excellent cooperation between the emergency services in Newtown and

this training could make it even easier for us to work together," Chief

Lysaght said.

The chief said that when Newtown's police officers come out of the police

academy, they are certified in CPR and as MRT's. But they haven't been able to

maintain their certifications because the costs of this ongoing training

hasn't been part of the department's budget.

"I believe my officers would jump at the chance to have this training," he

said. "I think it's an importance part of police service and would be a

logical progession of delivering emergency services to the community."