7.6. SR 12-16-1996 - Laserfiche WebLink

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Cover Story: Rochester Police Early Defibrillation Program by John Sibley How many of us that live in this Northern climate have experienced the problem of a dead battery in our vehicle in the middle of winter? It would proba- bly be safe to say that almost all of us have been faced with such a problem at one time or another, some perhaps a number of times. And how does the average motorist deal with the problem? Some may call for a towing or starting service, which often takes quite a while and costs more than they want to spend. More likely, the majority of us carry those simple, inexpensive devices called jumper cables. We hook one end of them up to the dead battery and the other end to the good battery from a friends car, and before you know it we are on the road again. Pretty simple ... right? Well, what if someone told you that, of the more than 250,000 Americans who die each year of sudden cardiac death, 20 to 25 percent of them could survive if a device were used by folks like you and me, that is almost as simple to use as the good old jumper cables. As it happened, about six years ago, that very message was presented to mem- bers of the Rochester Police Department. A proposal is made In the fall of 1990, Dr. Roger White, of the Mayo Clinic, came to the Rochester P.D. with a rev- olutionary idea. Dr. White is with the Mayo Department of Anesthesiology, and is a long- time medical director of the Gold Cross Ambulance firm of Rochester, specializing in cardiac arrest response. His theory was relatively simple. Since police squad cars are out and about in the neighborhoods and areas of the city, twenty four hours a day, 4 THE MINNESOTA POLICE JOURNAL there is high probability that a police officer will arrive on the scene of a cardiac episode signifi- cantly sooner than an ambulance that would be responding from a fixed location. His analysis of response times in cardiac inci- dents over previ- ous years clearly showed that, in a significant num- ber of cases, the police squads were arriving on the scene of med- ical emergencies two to three min- utes or more before the ambu- lance crews, even though they are simultaneously dispatched via a joint link-up between the 911 center and Gold Cross dis- patchers. About 65 to 70 percent of all cardiac arrest victims are in a state of ventricular fibrillation or tachycardia during the early minutes following the arrest. In the former, the heart has uncoor- dinated electrical activity and cannot pump blood effectively. In the latter, the heart rate is sim- ply too fast to permit the ventri- cles to refill with blood and sus- tain consciousness. In either case, if normal rhythm is not restored, the patient will not sur- vive. Fortunately, the rhythm can be restored by means of early defibrillation ... delivery of an electrical shock that reverses these most common forms of car- diac arrest. In the past, the use of a defibrillator to deliver such a shock was considered best left to paramedics or those in the med- ical profession. Now, however, with the advances that have been made in battery and microchip technology, new portable defibrillators have been developed that require only a "Since police squad cars are out and about in the neighborhoods and areas of the city, twenty four hours a day, there is high probability that a police offwer will arrive on the scene of a cardiac episode significantly sooner than an ambulance that would be responding from a fi. red location." minimal amount of training To use. Dr. *vVhite's proposal was to place a number of these portable automatic units in Rochester P.D. squad cars for the purpose of conducting a clinical study over a two year period. With close coordina- tion between the officers, the ambulance per- sonnel and the 911 dispatchers, data would be collected that should tell us whether police officers carrying and using defib- rillators will significantly increase a cardiac arrest patient's chance of survival. Chief Pat Farrell and his administrative staff discussed Dr. White's pro- posal and decided to give it a try. We would be the first police department in the country to participate in such a study. Naturally, there were more ques- tions than answers at this point. A journey into uncharted waters Once the decision was made to proceed with the project, things started to move quickly. A com- pany near Seattle, SpaceLabs, Inc., had recently developed a new portable defibrillator appro- priately named First Medic 510. They offered to loan the project four units at no charge, for the duration of the study. The units arrived in early October and training was conducted over the next couple of weeks. All patrol personnel were trained by Dr. White and Gold Cross Ambulance paramedics. Since all officers were already certified as "first responders," the training (continued on next page)