Maryland Firefighters Take CPR to the Next Level

CPR, with its roots in Maryland, is now being taken to another level.

Just as firefighters on an engine have specific duties, crews also need designated responsibilities at cardiac arrests, explained Capt. Dale Becker, of Howard County Fire and Rescue.

Since an innovative program was instituted two years ago, the survival rate of witnessed cardiac arrests is 40 percent. In Seattle, it’s 50 percent.

But, the department is not willing to sit on its laurels. There’s much more to do to improve the quality of care, Becker says.

They’re also interested in helping spread the word about what it takes to make the difference.

Earlier this week, Howard County hosted a Resuscitation Academy instructed by medics and medical staff from Seattle. For two days, 60 responders from throughout the state as well as some from Pennsylvania, North Carolina and Montana learned the intricacies.

It was the first time that Seattle has taken its seminar on the road, according to Norm Nedell, a Seattle firefighter/paramedic and member of the RA faculty.

He said the staff was pleased to share their experiences.

Two years ago, Becker came back from Seattle after spending time with crews witnessing them in action on cardiac arrests.

“I came back and hit the ground running,” he admitted with a laugh.

Becker started with crews at one company, and spent 10-12 hours training. Each person has a designated responsibility – leader, chest compressions or ventilations.

Howard County providers have nicknamed the exercises – the dance.

During a demonstration, crews approached a manikin and proceeded to do their jobs. There was no confusion or loud discussion. The leader kept an eye on the monitor watching for quality chest compressions.

Nedell said establishing assignments ahead of time is essential for quality CPR and resuscitative efforts.

“We tell our people, if they look dead they are dead, start pushing on the chest…” Nedell said.

Changing the culture is a challenge, both Nedell and Becker admit. But, there has been movement.

When a call goes out for a fire, firefighters dash to get geared up and on the truck, but let it be for a cardiac arrest and the paces slows. Both say that’s beginning to change now.

Nedell said a vital component of the effort is to keep the EMTs in charge of CPR. “They own it. They don’t stop or look for direction with medics arrive. The EMTs keep doing the basics, and that allows the medics to do ALS.”

Dr. Kevin Seaman, the medical director for HCFR, credits the team approach for the success.

“We have a high rate of bystander CPR, rapid use of defibrillation, and a great hospital…”

Dr. Robert Bass, MIEMSS executive director, pledged to re-activate the Cardiac Arrest Task Force to see if they can help promote the program launched in Howard County.

“This is the beginning of the journey,” he said, adding that the state will assure that all elements to boost the program are in place.