Ore. Fire Department Lauded for Cardiac Arrest Response

Nov. 07--The Camas Fire Department leads the pack of first responders when it comes to tending to people with stopped hearts in Clark County, a recent report said.

The Resuscitation Outcomes Consortium, a clinical trial and outcome-oriented research group, recently reported that Camas has the highest survival rate of 11 Portland-area EMS agencies for people who suffer cardiac arrest before arriving at the hospital. The group also rated Camas fifth out of 102 participating agencies throughout the country.

All the Portland-area agencies -- including all EMS and fire departments in Clark County -- scored pretty well, said Dr. Lynn Wittwer, medical program director for Clark County's emergency medical services.

"The Portland area always rates pretty high compared to the rest of the country," he said.

Why is Camas leading the local departments?

"It's craftsmanship really," said Cliff Free, the Camas Fire Department's division chief of EMS.

He said his agency is also small enough that it can adjust faster to new techniques. "It's easier to turn the ship," he said.

The recognition should be shared with the paid staff and volunteers of East County Fire & Rescue and the Washougal Fire Department, Camas Chief Nick Swinhart said. Both agencies contract the Camas department to transport their patients.

Local agencies are using a method that emphasizes giving continual compressions to patients instead of alternating between compressions and rescue breathing, Free said.

"People are coming out of the hospital on their own power," Free said. "That's pretty amazing."

In 2010 the American Heart Association updated its recommendation on CPR, Wittwer said. Based on data collected over the past 20 years, it appears good, high-quality CPR is key to surviving a cardiac arrest out of the hospital, he said.

That means compressions should be "faster, deeper and with the least amount of time off the chest," he said. The association still recommends alternating between breathing and compressions, but that makes it hard to maintain the compression rate, he said.

First responders aim for 100 to 110 compressions per minute at a depth of more than two inches for adults, Wittwer said. EMS personnel try to not stop compressions for more than four or five seconds to check for heart activity, he said.

If compressions are done at the right rate, at the right depth with a minimum amount of stoppage, it can basically maintain blood pressure necessary to preserve life, Camas' Free said.

In many cases, using compressions will get patients to the point where the heart has some activity and can be shocked into a proper rhythm by a defibrillator, Free said.

In this case, the technique makes all the difference, he said.

"We've been preaching CPR for 30 years, and we've finally figured out how to do it right," said Capt. Jay Getsfrid, EMS administrator for the Vancouver Fire Department.

Getsfrid has been a paramedic for 30 years and said the past five have been the most exciting in his career because of research developments. Every EMS agency in Clark County is on the "cutting edge of research" because of participation in the consortium studies, he said.

"We're part of the group that helps make the rules that others are following," Getsfrid said.

The new technique appears to be working, but there isn't enough data yet to show a statistical change, Wittwer said.

There are about 300 cardiac arrests in Clark County each year. EMS personnel are able to get about a third of those patients to re-establish a heart rhythm and take them to the hospital, Wittwer said. Around 40 percent of those taken to the hospital are released.

The Camas Fire Department plans to continue participating in studies into the future -- especially ones like this that don't change how they do business, Free said.

He hopes that information can expand into other areas and lead to new conditions EMS personnel can treat.

Paul Suarez: 360-735-4522; https://www.twitter.com/col_cops; paul.suarez@columbian.com.

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