How Your Community Can Improve Survival from Sudden Cardiac Arrest
Publication Year: 2013
Published by: University of Washington Press
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Title Page, Copyright Page
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Foreword by Roger D. White, M.D.
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Cardiac arrest occurs in people’s homes as well as in public places. It can strike anytime. For decades, it has been the leading cause of death among adults. Given the magnitude of this public health problem, you might suppose that the highest priority of emergency medical services (EMS) would be to improve survival rates. It is true that....
Preface to the Second Edition
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In my line of work there is nothing more gratifying than speaking with a survivor of sudden cardiac arrest. Survivors are, needless to say, extremely grateful to their rescuers. The most common question they ask is how they can thank the people who saved their life. The rescuers are the people who are part of the EMS system and...
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Let me begin by expressing my appreciation to the people who make it all possible— the hundreds of emergency dispatchers, the thousands of EMTs, and the hundreds of paramedics in Seattle and King County. Special thanks also to the dispatch directors, fire chiefs, and training officers. We have a wonderful EMS system, and it is all because of you. I am so proud of the great work you do....
Guide to Terminology
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1. How We Die Suddenly
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Peter A. had been doing fine, considering. He and his wife, Joanna, had been enjoying his retirement from Boeing, and they found the suburban community of Redmond, Washington— close to Seattle and its urban attractions, but with the advantage of quiet streets and large lots—perfect for them. Their yard was big enough for Joanna to pursue her hobby of butterfly- and bird-attractive gardening....
2. A History of Resuscitation
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Jacob ben C. hauled the small fishing boat onto the shore. The catch was good. As Jacob mentally estimated the weight and calculated the extra shekels he’d have for Sarah’s pendant, the headache struck like a hammer blow—a blast of searing white light, knife blades down the neck and into the back, and a tidal wave of nausea. Jacob had but a moment to reflect how different this was from the minor aches he had been feeling deep...
3. Causes of Sudden Cardiac Death
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This chapter describes in greater detail the common and uncommon heart-related causes of sudden death as well as the non-heart-related causes.1 In King County, Washington, 72 percent of people who experience cardiac arrest and who receive care from emergency medical services have underlying heart disease as the cause of cardiac arrest. The remaining 28 percent suffer from a variety of causative conditions.....
4. A Profile of Sudden Cardiac Arrest
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Paul M., a firefighter, is grumbling to his lieutenant about all the extra work involved in a cardiac arrest, for himself and everyone else. But Paul and his lieutenant both know that his complaints are for show. Despite the detailed reporting requirements, these calls give him the most satisfaction....
5. Who Will Live and Who Will Die?
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Tom M. and his wife, Janet, walked into the gallery housing Grant Wood’s famous painting American Gothic at the Art Institute of Chicago. The gallery was crowded, as usual. Tom and Janet had to work their way over to the painting, and they were gazing at it with admiration when a wave of nausea broke over Tom. Sweating profusely, he looked for a...
6. Location, Location, Location: Best Places to Have a Cardiac Arrest
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The fire chief and the medical director from the City of D. spent the first day meeting with the Seattle Medic One battalion chief, visiting the alarm center, and riding all afternoon and into the evening with two paramedics. The second day they visited the quality improvement office to understand the data collection system and then had lunch with the Medic One medical director. Eventually the discussion came around to the issue of...
7. What Can Your Community Do?
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The coffee cup saved Mike J.’s life. Mike’s wife, Joan, heard it shatter and went running into the kitchen. She saw the shards on the floor, and her husband was slumped over the table. While shouting Mike’s name, Joan reached for the telephone. Within thirty seconds of the cup’s hitting the floor, she had dialed 911....
8. A Completed Life
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Ruth T. is eighty-five and is on a respirator in the ICU. Two IVs in her arms and one in her neck contain medications to keep her blood pressure up, her heart stable, and her brain from swelling. Her kidneys have failed, and her doctor has talked about dialysis with Ruth’s three children, who have flown in from out of town....
9. Putting It All Together
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Why do some communities succeed in treating cardiac arrest while others fail? It would be convenient if one variable could explain the wide difference in survival rates for cardiac arrest between those U.S. communities that are most successful in treating this major public health problem and those that are least successful. But that would...
10. A Plan of Action
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Is it possible to change an EMS system in fundamental ways? Can a community’s survival rate for cardiac arrest be dramatically and permanently improved? Is it possible to change not only a system’s culture but also its entire structure? I believe that the answer to these questions is an emphatic Yes. ...
11. A Vision of the Future
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Wouldn’t it be amazing if the following news story appeared in the New World Times
October 2050, Stockholm
Dr. William Oslerberg accepted the Nobel Prize in Medicine for the discovery of a new class of viruses, named “ﬁbriviruses,” that cause ventricular ﬁbrillation. The virus is acquired in childhood. It lies dormant for several ...
Addendum: Resuscitation Academy
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The tag line for the Resuscitation Academy is “improving cardiac arrest survival, one community at a time.” Since the first Academy class in 2009, we have been trying to do just that. The Resuscitation Academy, held twice a year in Seattle, is a joint effort of King County EMS (Public Health—Seattle and King County), Seattle Medic One (Seattle Fire Department), and the Medic One Foundation. Additional support comes ...
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Publication Year: 2013
Edition: Second Edition