Fire Department, taking a cue from pit crews, relearns resuscitation 

Over Easter weekend, the Missoula Fire Department was dispatched to assist a man who had collapsed while running on a treadmill at the YMCA and gone into cardiac arrest.

The city's first responders receive 50 or 60 calls like this each year, MFD Chief Jason Diehl says. The patient's life hinges on what happens during the first few minutes. A year ago, if the Y staff had just dialed 911, the man probably would have died. Missoula cardiac arrest patients who weren't given CPR by a witness had only a 3 percent survival rate, according to the department.

In this case, chief Jason Diehl says Y staff administered CPR and a portable defibrillator while engines were on the way. Doing so makes a huge difference. Patients who receive aid from a witness stand an 80 percent chance of living. The patient was recovering at the hospital a few days later, Diehl says.

But responses like the one at the Y remain an exception, not the rule. So last year MFD looked at what it could do to save more lives, and discovered a clue from the world of stock car racing.

Actually, EMS Coordinator Ron Brunell says, he stumbled upon it. "Honestly, I was surfing Facebook one night," he says. The Spokane Valley Fire Department had posted its patient survival rate, which was orders of magnitude higher than MFD's. Brunell decided to call them up.

The department, he learned, was using a "pit crew" approach to treating patients on-scene. The idea, generally, is that every first responder performs one very specific task—from keeping a finger on the patient's pulse to administering compressions to dealing with worried family members.

What that means in terms of humanpower is this: Instead of sending five responders to a scene, MFD would start sending 10. And instead of rushing the patient into an ambulance, the pit crew would stay on scene administering treatment for as long as 15 minutes.

Brunell trained everyone at MFD on the new procedure and retrained them on CPR. A year later, he says, it's showing results. MFD's survival rate for cardiac arrest patients has jumped from 3 percent to 22 percent.

"All we changed is how we do CPR," Brunell says.

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