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Case Study: How a Calif. PD is combating cardiac arrest

Although AEDs should be installed in as many locations as possible, outfitting a city's police force with the technology is particularly important


The following is paid content sponsored by Philips

Background:
When the heart fails, seconds — not minutes — could mean the difference between life and death. There are 326,000 EMS-assessed incidents of cardiac arrest that occur outside of hospitals each year. On average, fewer than 11 percent of the victims survive, according to the American Heart Association (AHA). Increasing access to potentially life-saving automated external defibrillators (AEDs) is a crucial step in attempting to raise the survival rate.

Over 20 years ago, a sleepy suburban town in the heart of the Silicon Valley started outfitting its first responders and city buildings with AEDs, and now serves as a prime example of such a program’s success.

Cardiac arrest survivors and the first responders who saved them gather together during the Sunnyvale Sudden Cardiac Arrest Survivor Reunion in 2003. (Photo courtesy of Steve Drewniany)
Cardiac arrest survivors and the first responders who saved them gather together during the Sunnyvale Sudden Cardiac Arrest Survivor Reunion in 2003. (Photo courtesy of Steve Drewniany)

Problem:
In 1994, the Sunnyvale Department of Public Safety (SDPS) — a consolidated public safety department made up of 204 first responders who are cross-trained as peace officers, firefighters and emergency medical technicians to serve the city’s 149,000 residents — began addressing the need for a more rapid response to life-threatening cardiac events.

“What we were looking at was how to improve survival from sudden cardiac arrest,” Steve Drewniany, Deputy Chief of the SDPS and head of the city’s AED program, said. “We were deploying fire apparatus to these EMS calls and thought, ‘Well, we have police cars out there in our city all the time, roaming around – can we get them [patrol cars] to calls faster?’”

The goals of the program were to increase access to AEDs and improve response times. According to the AHA, for every minute that a person is in cardiac arrest, the chances of successful resuscitation decrease by 7-10 percent. Drewniany, who worked as a paramedic and Advanced Cardiovascular Life Support (ALCS) instructor and instructor trainer before joining the SDPS, knew first-hand how much every passing second in a sudden cardiac arrest event mattered.

“When you think about how long it takes for someone to recognize that there’s an emergency, to quickly call 911, to start CPR, to give early defibrillation, for EMS to arrive and to get [the patient] to the hospital for appropriate care, those minutes make a difference,” Drewniany said. “When you start to talk about eight, nine, ten minutes before someone in cardiac arrest receives care, your chances of resuscitating the victim are very marginal. The more rapidly that you can get early recognition of what’s going on, give early CPR and early defibrillation, the greater the chance you’ll have of bringing somebody back.”

Solution:
After seeing the initial success of adding AEDs to the SDPS’ fire apparatus, the program rapidly expanded. Sunnyvale now has the devices in all SDPS patrol cars, marked staff vehicles, and city buildings — 101 in all — creating an environment in which AEDs can be quickly accessed almost anywhere. In the future, the hope is for AEDs to be as commonplace as fire extinguishers.

The city uses a combination of models manufactured by Philips – the OnSite in city buildings (designed for civilian use), the FRx in city pools (designed to be water-resistant), and the FR3 (specifically tailored to first responders) in patrol cars and other emergency vehicles. The SDPS chose the company initially because of the speed at which their products could deliver a shock compared to the longer time of the device Drewniany had previously used. He credits Philips' customer service and quality of their products as the reason for their continued relationship.

“We stayed with Philips because of the reliability of the devices, the robust nature of them, the customer service we received. The science behind it has proven to us that it’s one of the best devices out there,” Drewniany said.

After initial purchase, the devices require very little maintenance. Drewniany said the Philips AEDs the city uses, for example, come with an eight-year warranty and rarely need to be replaced. Pads — which must be switched out after every use — are the primary recurring cost.

Although AEDs should be installed in as many locations as possible, outfitting a city’s police force with the technology is particularly important for a number of reasons. Chief among them: speed and numbers.

Typically, there are more police officers on the street and mobile at one time than there are fire or EMS responders. Because cops are out in the community already, and because their smaller vehicles are usually capable of getting around more quickly than a paramedic unit or a fire engine, police officers are arguably in the best position to deliver initial treatment to a victim of heart failure. Because of this, Sunnyvale police officers are now dispatched first to any calls identified as having a high likelihood of being cardiac-related.

Results:
Since the program started, there have been 63 confirmed saves the SDPS has credited to its use of AEDs. The survivors come from all walks of life, but they all share one thing in common: the city’s proactive measures saved their lives.

“People talk about ‘bringing somebody back’ in the abstract sense, but really what it means and what we’ve seen from these 63 people that we know of — they’re there for another Christmas, they’re there for another birthday, they’re there to see their kids born,” Drewniany said. “We’re finding people 15, 20 years later are still alive.”

The city also holds an annual ceremony in its city council chambers celebrating the officers and the civilians they saved — which both increases the visibility of the good that the officers are doing in the community every day, and further reinforces to the agency’s staff that they are making a difference in the world.

Saves aren’t just limited to first responders, either. Since the SDPS installed the civilian-friendly models (in which a calm, clear voice explains exactly what to do) in city buildings, there have been multiple cases in which an untrained community member has rescued someone in need.

“We all get into this job to help people. Our primary goal is to protect life. By saving somebody’s life, you’re doing what you really got into this to do. It’s hard to put into words what that does — it’s pretty amazing,” Drewniany said.

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