Can college campuses act as springboards for the advancement of chain of survival priorities?
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Can college campuses act as springboards for the advancement of chain of survival priorities?

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Review current evidence based guidelines and recommendations. ...

Review current evidence based guidelines and recommendations.

Describe how a population and criteria based incentive program has been used to advance chain of survival priorities on college campuses.

Discuss the role of college based EMS agencies in advancing lifesaving priorities.

Explore the possibilities of widespread CPR education on college campuses using CPR Anytime.

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Can college campuses act as springboards for the advancement of chain of survival priorities? Can college campuses act as springboards for the advancement of chain of survival priorities? Presentation Transcript

  • Can college campuses act as springboards for the advancement of chain of survival priorities? 15 th Annual National Collegiate EMS Foundation Conference Philadelphia, PA March 2, 2008
  • Objectives
    • Review current evidence based guidelines and recommendations.
    • Describe how a population and criteria based incentive program has been used to advance chain of survival priorities on college campuses.
    • Discuss the role of college based EMS agencies in advancing lifesaving priorities.
    • Explore the possibilities of widespread CPR education on college campuses using CPR Anytime.
    • Provide an opportunity for additional dialog and collaboration between the AHA, NCEMSF, and other stakeholders.
  • Guidelines
    • 2005 International Consensus on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) Science with Treatment Recommendations (CoSTR)
    • Scientific consensus of experts from a variety of countries, cultures and disciplines. 
    • Recognized experts were brought
    • together by the International Liaison
    • Committee on Resuscitation (ILCOR)
    • to evaluate and form an expert consensus
      • on all peer reviewed scientific studies
    • related to CPR and ECC.
    1974 1980 1986 1992 2000 2005
  • What’s New and Why These changes are presented because they have the potential to impact specific actions taken by you on scene or the protocols for treatment and operations that are used in your particular EMS system.
  •  
  • Basic Focal Points
    • The 2005 Guidelines place great emphasis on
    • Improving the quality
    • of CPR delivered by all
    • providers
    • Increasing the chance
    • that a cardiac arrest victim
    • will receive bystander CPR
  • BLS Changes
    • Providing high-quality CPR with special
    • attention to chest compression depth and rate,
    • permitting complete chest wall recoil and
    • minimal interruptions to compressions.
    All rescuers acting alone should use a 30:2 ratio of compressions-to ventilations for all victims except newborns.
  • BLS Changes
    • Avoid over-ventilation: too many breaths
    • per minute or breaths that are too large
    • or too forceful.
    Avoid death through hyperventilation!
  • BLS Changes
    • When two or more health-care providers
    • are present during CPR, rescuers should
    • rotate the compressor role every two
    • minutes.
    Rescuers fatigue before they tire. Switch often.
  • BLS Changes
    • Ventricular fibrillation (VF) cardiac arrest, use a
    • single shock, followed by immediate CPR for
    • two minutes, starting with compressions first.
    Use a single shock. Pictures are for presentation purposes only. The American Heart Association does not endorse any particular products, models or manufacturers.
  • BLS Changes
    • For adult out-of-hospital cardiac arrest that is
    • not witnessed by the EMS provider, rescuers
    • may give a period of CPR (about two minutes)
    • before checking the rhythm and attempting
    • defibrillation.
    This requires protocol development.
  • Early Defibrillation Strategies
    • Campus Police
  • ACLS Changes Do QUALITY CPR!
  • ACLS Changes
    • Recommended use of endotracheal (ET)
    • intubation is limited to providers with
    • adequate training and opportunities to
    • practice or perform intubations.
    • Confirmation of ET tube placement
    • requires both clinical assessment and
    • use of a device.
  • ACLS Changes
    • Organize care to minimize interruptions
    • in chest compressions for rhythm check, shock
    • delivery, advanced
    • airway insertion or
    • vascular access.
    Pictures are for presentation purposes only. The American Heart Association does not endorse any particular products, models or manufacturers.
  • ACLS Changes Pictures and images are for presentation purposes only. The American Heart Association does not endorse any particular products, models or manufacturers.
  • Gadgets Pictures are for presentation purposes only. The American Heart Association does not endorse any particular products, models or manufacturers.
  • To Cool is to be Cool Unconscious adult patients with spontaneous circulation after out-of-hospital cardiac arrest should be cooled to 32°C to 34°C for 12 to 24 hours when the initial rhythm was ventricular fibrillation (VF). Pictures are for presentation purposes only. The American Heart Association does not endorse any particular products, models or manufacturers.
  • No Ventilation CPR? NO Guideline change at this time!
  • So Far We Know…
    • Do quality BLS!
    • Do not over-ventilate!
    • Switch compressors!
    • Single shock
    • Organize care
    • Value of 12 lead
    • Technology
    • Cooling beneficial
  • Increasing the Chances that a Cardiac Arrest Victim Will Receive Bystander CPR
    • 70-80% SCA in and around home
    • Less than 1/3 get CPR before EMS
    • Fewer still get quality CPR
    • Time to intervention and survival relationship is well established
  • Sudden Cardiac Arrest by Location Residence is most common location!
  • Can’t Get There in Time
  • OPALS Studies and OPALS Cardiac Arrest Database [OCAD]
    • Phase I demonstrated the importance of bystander CPR in patient survival in 4,690 patients.
    • Phase II demonstrated, in an additional 1,641 patients, that the inexpensive optimization of an existing defibrillation program could lead to significant improvements in survival.
    • Phase III, 36 months with a full ALS paramedic program, enrolled an additional 4,247 patients and showed no incremental benefit in survival from ALS but was the first study to quantify the importance of the links in the cardiac arrest chain of survival.
  • So Now What?
  • Recommendations
    • “Community Coronary Care Units”
    • Organized response to emergencies
    • EMD
    • Citizen CPR
    • Early defibrillation
    • Effective BLS and ACLS
    • Early detection of ACS
    • Early definitive intervention
  • HEART Safe Community
    • A population and criteria based incentive program designed to advance systems change and chain of survival priorities.
  • HEART Safe
  •  
  • MIT
    • "It is the story of how the
    • vision of a hard-working
    • engineering student, then
    • alum, ignited fellow
    • students, alumni, faculty
    • and staff around the goal of
    • ready access to life-saving
    • care on campus"
  • HEART Safe Community
    • Lobby to become a HEARTSafe Campus in FL, MA, NH, CT, and ME.
    • Explore possibilities of creating a similar program?
  • And Now We Also Know… How a population and criteria based incentive program has been used to advance chain of survival priorities on college campuses.
  • Can College Based EMS Agencies Advance Lifesaving Priorities? Pictures are for presentation purposes only. The American Heart Association does not endorse any particular products, models or manufacturers.
  • Why?
  • How?
    • Quality Training
    • Quality Care
    • Development of Good Habits, Early
    • Future Leaders
    • INFLUENCE CAMPUS
    • and COMMUNITY MENTALITY
    • and BEHAVIOR
  • CPR and Behavioral Change
    • Commercial marketing expensive and often ineffective
    • Social marketing experience is good
    • Incentive change methods offer a less expensive option
  • CPR Issues
    • Multiple barriers
    • Time limitations
    • Costs
    • Manpower
    • Engagement
    • Relevance
  • Best ROI
  • The BIG Questions
    • How can we get large numbers of people to learn CPR?
    • How can we encourage
    • people to be willing to
    • perform CPR?
  • Traditional CPR
    • 2-hour course
    • 3 (+/-) students/manikin
    • 6 (+/-) students/instructor
    • Students get minimal skills practice
    • Can be logistically difficult for students and instructor
  • Reasons to Create a More User Friendly Method
    • Reduce course time to increase participation
    • Reduce reliance on an instructor to increase training availability and efficiency (facilitators do not need to be certified instructors)
    • Use a video self-instructional format to make home use possible
    • A simpler and friendlier presentation to increase trainee self-confidence
  • Family & Friends CPR Anytime : Self-directed Training for the Community
    • A personal, inflatable CPR manikin, “Mini Anne”
    • An American Heart Association Family & Friends ™ CPR booklet
    • CPR Skills Practice DVD
    • Accessories for the program
  • The Multiplier Effect
    • Even when individuals use the CPR Anytime products in a group setting, they are given their kit to share with others at home
    • Some programs have reported an average of more than 3 additional users per kit!
  • Efficacy of CPR Anytime
    • CPR Anytime trainees “tended to have better overall performance” than did those who were traditionally trained in a two-hour CPR course
    • Resuscitation 67 (2005) 31–43
  • Retention of CPR Skills using CPR Anytime
    • Retention of basic skills is as high for this shortened program as it is for traditional training courses
    • Since the people are able to keep the training kit, they can conveniently refresh their skills at will
  • Doing it BIG
  • Passion… Pictures are for presentation purposes only. The American Heart Association does not endorse any particular products, models or manufacturers.
  • Wrap
    • Improving the quality of CPR delivered by all providers
    • Increasing the chance that a cardiac arrest victim will receive bystander CPR
  • Questions
    • Are you “connected” with the AHA?
    • Is there room for expanding your agencies “footprint” on campus?
    • Does widespread CPR “fit” with performance improvement, recruiting, and other efforts?
    • Are you satisfied with “status quo”?
    www.americanheart.org www.cpranytime.org [email_address]
  •  
  •  
  • Parting Message Pictures are for presentation purposes only. The American Heart Association does not endorse any particular products, models or manufacturers.
  • Thank you!