Cardiac Ready Communities Initiative

 

Montana Cardiac Ready Communities logo

The Problem

Several specific conditions fall under the category of cardiovascular disease: cardiac arrest, heart attack, stroke, heart failure, and arrhythmias. Other conditions affecting the heart and vascular system are less common. Cardiac arrest, hearts attack and stroke are all medical emergencies and need immediate intervention. 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). 

Heart attack, medically known as a Myocardial Infarction (MI) is the blockage of a blood vessel within the heart. The blockage prevents oxygen and nutrients from getting to the heart muscle, leading the tissue to die. Patients typically have symptoms alerting them to a heart attack including chest pain and shortness of breath. Calling for an ambulance and prompt treatment at a hospital can reduce permanent damage to the heart. Heart failure is when the heart muscle or a valve is weakened due to a heart attack or illness. Blood is not being properly pumped to the body and patients suffer from fatigue, edema in the extremities and difficulty breathing. Arrhythmias are abnormal heart rhythms and some can cause cardiac arrest. Another common arrhythmia is atrial fibrillation (AF). When a person has AF, the top chambers of the heart do n ot work properly and they "flutter" rather than contract to pump blood. Unmanaged AF is the leading risk factor for a stroke. 

A stroke is the interruption of blood flow to the brain. The most common type is due to a blockage, similar to a heart attack. Another type of stroke is due to a broken or ruptured blood vessel that causes uncontrolled bleeding and pressure in the skull, damaging the brain. Common symptoms of a stroke are weakness on one side of the body, facial droop, difficulty speaking, and less of balance. Calling for an ambulance and prompt treatment at a hospital can reduce damage to the brain.

Cardiovascular disease is the leading cause of death in Montana. Many patients die before reaching a hospital. When a cardiovascular emergency occurs, a fast and accurate medical response is crucial. Each minute that the heart or brain is deprived of oxygen increases the chances of damaging or destroying part of the tissue. Calling an ambulance gives these patients the best chance of survival and limited disability.

The Project

In collaboration with stakeholders including EMS services, hospitals, community leaders and the public, Montana Cardiac Ready Communities project work to enhance many essential elements of the cardiovascular chain of survival: a public education campaign on signs and symptoms of cardiovascular emergencies and the need to activate the 911 system; 911 dispatchers trained in emergency medical dispatch (EMD); citizen hands-only CPR; public access defibrillation programs; training on high performance CPR for ambulance services and hospitals; and system-wide data tools for quality measurement and improvement.

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 emergency cardiovascular care system 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 patients. 

Project Strategy

Provide leadership to facilitate the development and implementation of components of an emergency cardiovascular care system using data driven interventions for PI/QI projects. Components include emergency medical dispatch, public hands-only CPR and AED response, EMS response, hospital response and treatment and rehabilitation. Several semi-annual and annual data reports will be generated for EMS agencies, hospitals and the general public to assist with these projects.

Proposed Project Outcome

Increase survival and decrease disability from cardiovascular emergencies through the development and implementation of high-performance emergency cardiovascular systems of care in Montana.

Creating an Emergency Cardiovascular System of Care in Montana Poster

Videos

AED Trooper Photo 

AED Player Photo