Nov. 27--Improvements in technique and technology are helping Portland's emergency medical personnel rescue significantly more heart attack victims by increasing the effectiveness of cardiopulmonary resuscitation, or CPR, that they provide.
The survival rate for cardiac patients treated and transported by Portland Fire Department's MEDCU workers jumped to 17 percent so far this year. Last year, 6 percent of the cardiac patients survived.
"This represents a tremendous improvement in our system," said Matthew Sholl, head of emergency medicine for Maine Medical Center and the fire department's medical director. That compares to an average national survival rate of about 6 percent, with individual departments ranging from 2.2 to 16.6 percent, he said.
Sholl was speaking to a group of firefighters Tuesday at the Stevens Avenue Armory as part of the department's grand rounds, a monthly exercise where they share lessons learned in major cases from the previous month.
Last month, the department responded to five cardiac arrests, saving two of them. One was an 81- year-old woman and the other a 71-year-old man. In both cases, they were discharged from the hospital after surgery, with little or no neurological damage, he said.
The improved survival rate stems from new techniques advocated by the American Heart Association, said Lt. John Kooistra, the department's quality assurance officer. Instead of trying to get a patient into the ambulance and to the hospital as quickly as possible, firefighters now deliver 20 minutes of uninterrupted CPR.
That has been shown to improve survival rates by keeping the blood flowing to vital organs, Kooistra said. Even brief interruptions, to move a patient down stairs or into the ambulance, can have serious consequences, he said.
The department also has invested in new technology, devices that monitor the frequency and depth of CPR compressions. If the person delivering CPR doesn't press down far enough, the blood won't get pushed out to the organs that need it, he said. If the compressions are too rapid, the heart won't refill with blood. If compressions aren't ot rapid enough, the organs lack adequate oxygen.
The devices not only alert firefighters if the CPR is too shallow or too rapid, but also keep a record of it so the department can review its practice later, Kooistra said.
Copyright 2012 - Portland Press Herald, Maine
