County Fire Rescue among nation’s best
Published: Wednesday, January 2, 2013 at 6:01 a.m.
Last Modified: Monday, December 31, 2012 at 7:14 p.m.
Dave Feather was having a normal Monday afternoon on Sept. 24, working on the roof of his house in Gainesville's Durant Estates neighborhood. He came inside, drank some water, ate half a sandwich and washed his hands at the kitchen sink.
And then, he collapsed. He remembers nothing until he woke up Wednesday afternoon.
"I was perfectly normal, and then perfectly gone," recalled the 61-year-old.
It wasn't a heart attack, which he'd had 14 years earlier. Feather had experienced sudden cardiac arrest, a condition in which the heart stops beating. External electric charges, or defibrillation, often are used re-start a heart in such cases.
Alachua County Fire Rescue picked up 140 people with cardiac arrest in 2011, and resuscitated 52 of those. Of those 52, 20 eventually left the hospital. These patients are called "saves," and Feather was one of this year's saves.
Alachua County Fire Rescue has a save rate of 37.1 percent — nearly double the national rate of less than 25 percent.
The agency attributes at least part of its success to the teamwork that immediately goes into play during emergency situations. The agency has 190 people in its crew, and teams of four and five people are sent to emergency situations.
Jennifer Blakeney was on the team that assisted Feather.
"You have so many extra hands. Everybody has a job, so there are more people that can get things done quicker," Blakeney explained.
She was responsible for inserting an IO, or intraosseous infusion, into Feather's leg, to quickly access the venous system. Other people in the rescue squad performed CPR and opened Feather's airway.
"We started to give him the meds, but at some point you have to gather all your things and get on the truck," Blakeney said. "As we got him on the truck, he moaned. I've been a paramedic for six years, and I've only had that happen twice."
Feather's recovery stands out in Blakeney's mind, but Alachua County Fire Rescue hopes such saves become increasingly routine with some new measures.
For example, the agency has an "enhanced 911 service." When a person calls 911 and says they are with a person who is not breathing, fire rescue personnel give them instructions on providing chest compressions and stay on the phone until paramedics arrive. That was true in Feather's case — his wife performed CPR on him while his daughter stayed on the phone with 911.
This year, the agency will start using devices that assist with CPR, to avoid responder fatigue. It also uses stroke alert and EKG alert systems that automatically transmit data to hospitals before patients arrive.
"By the time we get to the hospital, that patient is ready to go," said Harold Theus, assistant chief of EMS. "This leads to the prevention of cardiac arrests."
Theus also said fire rescue uses more stringent criteria for determining whether to actually resuscitate a patient.
"There have to be obvious signs of death — multiple criteria have to be met before that happens," he said.
Alachua County Fire Rescue also educates the public about what to do in emergency situations until they get there.
People can become certified in CPR through the American Red Cross or American Heart Association, but it's important to remind them of certain techniques, Theus said. For example, in 2010, the American Heart Association moved away from ventilation and toward compression, he said.
"So we can teach a lay person that it's OK to use hands only. By moving that blood flow around, your body has enough oxygen in it to sustain it until EMS arrives," Theus said.
In Alachua County, many of the cardiac arrest cases occur in densely populated areas such as Gainesville.
Patients are much more likely to survive if cardiac arrest occurs in a public place where they are seen, said Theus, adding that because of the two main hospitals in Gainesville, the crew is never more than 10 minutes away from one of them.
In Feather's case, just 12 minutes went by from the time the EMS crew entered his home to when they arrived at the hospital.
For his wife, Cheryl, those life-saving 12 minutes made her realize just how crucial EMS teams are to patients' survival.
"I hope that I would never have to use them again, but I am confident that if I did need to, that they would respond," she said. "It certainly has made me so much more aware when I hear an ambulance now. I hear it as a sign of life coming your way."
Kristine Crane is a Gainesville Sun staff writer.