HEARTSafe New Hampshire-Reflections
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HEARTSafe New Hampshire-Reflections

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Recently, fourteen New Hampshire communities were designated as HEARTSafe by the New Hampshire Bureau of EMS, their Department of Public Health and the American Heart Association after taking part......

Recently, fourteen New Hampshire communities were designated as HEARTSafe by the New Hampshire Bureau of EMS, their Department of Public Health and the American Heart Association after taking part in an effort to improve response, care and outcomes for victims of cardiac arrest. These communities have increased the number of residents skilled in CPR, educated them about the importance of quick response and have strategically deployed automated external defibrillators, among other measures. In recognizing these local achievements, the towns are provided with HEARTSafe Community road signs. Related article: http://www.wmur.com/health/30483785/detail.html#ixzz1mqJQ3pnA But what does this mean? Let’s start by looking at the populations of the communities, the annual projected number of cardiac arrests, and estimated survival rates at 5%, 10%, and 20%.

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  • 1. Recently, fourteen New Hampshire communities were designated as HEARTSafe by the NewHampshire Bureau of EMS, their Department of Public Health and the American HeartAssociation after taking part in an effort to improve response, care and outcomes for victims ofcardiac arrest.These communities have increased the number of residents skilled in CPR, educated themabout the importance of quick response and have strategically deployed automated externaldefibrillators, among other measures. In recognizing these local achievements, the towns areprovided with HEARTSafe Community road signs.Related article: http://www.wmur.com/health/30483785/detail.html#ixzz1mqJQ3pnABut what does this mean? Let’s start by looking at the populations of the communities, theannual projected number of cardiac arrests, and estimated survival rates at 5%, 10%, and20%.Chester, NH Population: 4,800Concord, NH Population: 43,000Goffstown, NH Population: 18,000Henniker, NH Population: 4,800Hudson, NH Population: 24,500Keene, NH Population: 23,500Lancaster, NH Population: 3,500Peterborough, NH Population: 6,300Portsmouth, NH Population: 21,200Rochester, NH Population: 29,800Swanzey, NH Population: 7,200Walpole, NH Population: 3,700Woodstock, NH Population: 1,400Combined population of above communities: 191,700Anticipated number cardiac arrests (annual): ~190Number surviving (5% survival rate): 9Number surviving (10% survival rate): 19Number surviving (20% survival rate): 38
  • 2. As I have mentioned, along with countless others, communities must be recognized as “ultimatecoronary care units”. By doing so, we can take some relatively simple steps to effectivelyincrease survival and improve outcomes from sudden death. Community wide interventions thatwill improve overall resuscitation quality and increase the likelihood of early bystander initiatedCPR and prompt defibrillation are critical aspects of any effort to reduce death and disabilityfrom out-of-hospital cardiac arrest.An optimal strategy is one that actively engages a community at all levels. HEARTSafe programshave effectively advanced a full spectrum of survival priorities spanning signs and symptoms,EMD, bystander CPR, early defibrillation strategies (including LEA), early STEMI identification,ACLS education, and more.HEARTSafe Community Programs are population and criteria based incentive programs that aredesigned to help municipalities of all sizes to plan, develop, and implement chain of survival andsystems change strategies.This link http://tinyurl.com/3zjxcjm will help you access programs so you can examineunique program attributes relating to interagency collaboration, media engagement and bestpractices in application. Our goal is to expose more people to the concept of HEARTSafe andinspire and enable them to design, implement and promote similar strategies in more locationsacross the world.Fully 50% of men and women in western society with serious coronary artery diseaseexperience their first signs of the disease in a dramatic way—sudden cardiac arrest.Whether a victim lives or dies at this point depends on whether the collapse is witnessed, if thepeople who are there are trained and WILLING to perform CPR, and whether the arrest hasoccurred in a system that can bring about early arrival of needed resources and execution ofevidence based (timely) interventions.Many have recognized the need to improve community systems of emergency cardiovascularcare to optimize patient survival. The "Chain of Survival" represents the current approach toimproving recognition, response, care and outcomes.Decades later, this same systematic, organized, coordinated effort in a community remains thestrongest recommendation the resuscitation community can make to save more people fromout-of-hospital cardiac arrest (although I have no business being a “representative of thecollective opinion” of the resuscitation community).The central question to be answered is whether a community’s system exploits resources andimplements measures and strategies to achieve optimal (and attainable) patient survival.I find that there are numerous systems where implementation of modifications aimed atoptimizing treatment for patients has lead to improved outcomes for critical out-of-hospitalpatients. I believe that concepts and programs such as the Heart Rescue program andHEARTSafe Communities are essential frameworks for utilization by any group looking toadvance related strategies to improve survival, systems and quality of life.
  • 3. New treatments have improved the possibility of survival from cardiovascular emergencies andcardiac arrest offer the hope of improved quality of life for people who suffer these events.Community based CPR efforts and education are needed in as many locations as possible.Experience supports the value of early CPR by citizens and a community approach to supportingand guiding systems development.Strategies like HEARTSafe help to remove barriers that discourage development ofcomprehensive strategies to enhance survival probability and aid in creating community-widechange.