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Cardiac Ready Communities

Cardiac Ready Communities Initiative

 

Montana Cardiac Ready Communities logoThe Montana Department of Public Health and Human Services is pleased to be the recipient of a gift of $3.2 million from The Leona M. and Harry B. Helmsley Charitable Trust, one of the nation’s largest foundations, to implement a three-year Cardiac Ready Communities initiative in Montana.

The Problem

Cardiac arrest is a condition in which abnormal heart rhythms, called arrhythmias, cause the heart's electrical impulses to suddenly become chaotic.  When cardiac arrest occurs, the heart stops abruptly, the victim collapses and quickly loses consciousness.  Death usually follows unless a normal heart rhythm is restored within minutes.  The recommended protocols for treating cardiac arrest include cardiopulmonary resuscitation (CPR) and defibrillation (electric shock to the heart). 

Over one-quarter of all deaths in Montana are attributed to cardiovascular disease. Many of these patients will die before reaching a hospital. When a heart attack occurs, a fast and accurate medical response is crucial. Each minute that the heart is deprived of oxygen increases the chances of damaging or destroying part of the heart muscle. About 80 percent of out-of-hospital cardiac arrest occur in private or residential settings, yet only a third of these patients receive bystander CPR.

The Project

In collaboration with stakeholders including EMS services, hospitals, community leaders and the public, this Montana Cardiac Ready Communities project will enhance many essential elements of the cardiac arrest chain of survival: a public education campaign on heart attack signs and symptoms and the need to activate the 9-1-1 system; citizen hands-only CPR; public access defibrillation programs; training on high performance CPR for ambulance services and hospitals; and a system-wide data tool for quality measurement and improvement. Targeted funding will be provided to deploy automatic compression devices to EMS services and hospital to aid in the delivery of quality CPR and cardiac care.

This initiative represents a significant investment in Montana’s emergency medical system, especially in our rural areas. There is a great need for development of a statewide cardiac care program for Montana which helps stimulate better patient outcomes from cardiac events. The rural nature of Montana often prevents even the best of emergency service systems from arriving at rural scenes in time to help cardiac arrest patients. Hence, the development of Cardiac Ready Communities around the deployment of automatic compression devices offers a unique opportunity to improve several elements of a system of cardiac care.

A key strategy of this project is to advance care in all EMS agencies and hospitals in the State by installing automated chest compression devices to perform CPR when cardiac arrest patients present or are encountered. Because the automated chest compression device delivers effective and consistent chest compressions with a minimum of interruptions, implementation of this life-saving equipment will provide the patient with the best available chance for survival. CPR performed at consistent depths and rates of compression, and with minimal interruption, improves outcomes while the patient is being treated and transported as well as in the hospital. Utilization of chest compression devices has the potential to increase survival rates 30% to 50%. Specific benefits of the equipment include:

► The chest compression device performs 100 compressions per minute with a depth of 2 inches with the same efficiency for all patients.

► The device allows for complete chest wall recoil after each compression and provides a 50% duty cycle, which allows for equal compression and relaxation time for the chest wall.

► Restoring blood flow to normal levels will help responders establish an intravenous line due to the inflation of the veins making it easier to find a vein to start the line and administer appropriate drug therapies.

► The automated chest compression device will circulate drugs faster and more completely improving the chances of inducing a rhythm that can be defibrillated. 

► Using the device will reduce the stress and strain on responders and make the transport safer as the responder can be seated to perform treatment instead of standing over the patient.

► The device reduces rib fractures and cartilage damage compared to manual compression during CPR.

Project Goal

Equip EMS services and hospitals with automated CPR devices as well as support a broader goal to increase survival from sudden cardiac arrest through Cardiac Ready Communities.

Project Strategy

Provide leadership to facilitate the development and implementation of components of Cardiac Ready Communities including use of dispatch CPR, public hands-only CPR and AEDs, as well as EMS and hospital high performance CPR enhanced with automated compression devices.

Proposed Project Outcome

Increased survival of cardiac patients through development and implementation of a high-performance cardiac care system.

Early Access - Early CPR - Early Defibrillation - Early Advanced Care