1. Saving Santa Barbara How Saving Our Patients is Saving Our Responders!

2. Les Hugie, EMT-P, Clinical Education Specialist
Jennie Simon, RN – Clinical Quality Improvement Coordinator Emergency Medical Services Agency Santa Barbara County
Les Hugie, EMT-P, Clinical Education Specialist
American Medical Response Santa Barbara County
Josh Cazier, EMT-P, Training Captain
Santa Barbara County Fire Department
Chris Mailes, EMT-P, Battalion Chief
Santa Barbara City Fire Department
Mark Clayton, EMT, Battalion Chief
Lompoc City Fire Department
Shane Fabie, EMT-P Field Training Officer
Joseph DeAnda, EMT-P Field Training Officer .
No presenter has a financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the context of the subject of this presentation

3. Introduction

4. SAVING SANTA BARBARA
Our local EMS community is re-energized as a result of the vast improvements in our cardiac arrest survivability.
A system-wide approach has brought a sense of value to dispatchers, EMTs, medics and firefighters who witness their efforts save lives!
Examples of real-life Cardiac Arrest calls being handled by a Dispatcher performing Emergency Medical Dispatch (EMD) to identify Cardiac Arrest and provide appropriate hands only CPR instructions to bystanders prior to the arrival of EMS.
Provide examples of paramedics and EMTs describing cardiac arrest calls where they utilized specific components of the local Cardiac Arrest Management Program strategies, and ROSC was achieved. These segments will illustrate several links in the chain of survival.
Participants will be able to associate the sense of professional and personal value reported by the EMS Responders, with the utilization of Cardiac Arrest Management techniques when encountering a cardiac arrest patient.
Participants will be able to identify three strategies, cited by administrators of local Fire Departments and Ambulance companies, which support utilizing an integrated approach for the implementation of a Cardiac Arrest Management program in to a local prehospital system.
ECCU Session Objectives
Describe one or more survivor/rescuer stories that will be used to illustrate an effective chain of survival for cardiac arrest.
Describe how to implement three (3) effective CPR training techniques in your EMS system or community.

5. 410 Cardiac Arrests Annually Average
Santa Barbara County
Population 440,668   (2014 Census) 3,789 square miles
7 Fire Departments
(BLS & ALS)
1 Private Ambulance
(ALS)
170 Paramedics 
520 EMTs
5 Hospitals
410 Cardiac Arrests Annually Average
(230 CARES / 180 Non-CARES)

6. Dispatch

7. How CAM started in Santa Barbara county
Joined the CARES Network (April)
Under guidance of Santa Barbara County EMS Agency Medical Director, Dr. Angelo Salvucci
2011 – Refined our Cardiac Arrest Data Collection Process
Identifying calls
Partnering with Hospitals for Outcome Data
Sorting out field documentation for accurate data
Discovering how to capture both ALS and BLS data
2012 – First solid year of “Reliable Data”

9. Cardiac Arrest Management (CAM)
System of care:
Evidence-based treatment protocols
Targeted, goal-directed education
Individual and team training
QI program with process and outcome measures
Commitment of all participants
This would be the “what you implemented” with some specifics included (what is targeted goal directed education? All EMS personnel received x hours of hands on…)

10. GOAL
To maximize the number of cardiac arrest patients that wake up and return home to their families.

11. STRATEGIES: EMS Assigned defined roles Rapid and accurate assessment
Adequate work space
Continuous high quality chest compressions
Prompt defibrillation
Airway & synchronized ventilations
ALS: Vascular access with medications
Emphasis on teamwork
Recognition of ROSC
How to achieve the goal

12. STRATEGY : ROLES
Health care providers feeling pulses not reliable, and can delay start of chest compressions.
Description of “shark hook” using one finger under chin to open airway – compressions deliver 200 cc air per compression 12

13. roles

14. Cardiac Arrest: The Prime Directive
STRATEGY:
CONTINUOUS COMPRESSIONS
Cardiac Arrest:
The Prime Directive
Continuous high-quality chest compressions will be performed from the moment of arrest until return of spontaneous circulation.
STAY ON THE CHEST!!!!
Quality chest compressions: rate/depth/recoil
Switch every 2 minutes
Discuss position and hand position

15. compressions

16. STRATEGY : TEAMWORK TEAM PRIORITIES: Know your role
Assume proper position
Continuous chest compressions
Synchronized ventilations
Switch compressor every 2 minutes
Morning checks include role assignments for CPR

17. teamwork

19. CLOSING comments

20. Panel Questions

21. THANK YOU!! For Further Question Contact:
Jennie Simon, RN