“Your friend here is only mostly dead. There’s a big difference between mostly dead and all dead,” says Miracle Max (Billy Crystal) in The Princess Bride. “Mostly dead is slightly alive.”
So what does the Miracle Max scene have to do with saving someone who is in cardiac arrest?
“It’s the scene I show at the beginning of every CPR class I teach,” said David Weed, community services officer for Woodinville Fire & Rescue. “It’s to show them that if you start CPR right away, when someone is only mostly dead, they have a better chance of surviving a cardiac arrest.”
In the first half of the year, survivorship rates for heart attack patients first seen by firefighters has increased to 49 percent, compared to rates of 5-10 percent in many major urban areas, according to the Emergency Medical Service 2011 Annual Report, released by King County last week.
“The success our EMS system has achieved in providing excellent, standardized services countywide is quite remarkable,” said Dr. David Fleming, Director and Health Officer for Public Health – Seattle and King County. “Patient survival from cardiac arrest is one of the most critical measures of success for any EMS system, and survival rates in King County make our system the gold standard.”
In 2010, the EMS system responded to a total of 210,719 calls to 911, 47,012 of which were for advanced life support, according to the report. The average medic unit response time remained steady at 7.6 minutes.
It’s not just about response times; Woodinville’s average response times are between 5 and 6.3 minutes, even since the closure of one of the fire stations. It’s about the dramatically increased chances of surviving a cardiac episode if CPR can be started immediately and continues without interruption until an automated external defibrillator (AED) can be applied.
The key, said Weed, is starting CPR compressions to the chest within five minutes of the beginning of a cardiac arrest, that window of “mostly dead.” The report showed when that occurred, patient survivorship was above 50 percent. That’s where the community sometimes steps in.
“It was really Dr. Leonard Cobb of UW who started Medic One. It was his idea of taking citizens and having them perform CPR before the medical people arrive to increase survivorship,” Weed said. “You can have the greatest cardiologists and the greatest equipment in the world but if you can’t get the patient there alive, it doesn’t matter.”
Two cases immediately came to Weed’s mind to illustrate the importance of everyone having CPR training. In June a woman walking on the Tolt Pipeline Trail collapsed and two men passing by saw her, called 911 and started CPR. Crews responded quickly but they had to stop, unlock the gate and get to the scene.
“It’s very clear from looking at the response times if those two gentleman had not started CPR, there’s no way she would have had a chance of surviving that incident,” Weed said.
In another instance it was a pregnant woman who went into cardiac arrest. “And again because of CPR being done before our crews arrived, it was a happy ending. Both her and the baby survived.”
Woodinville Fire & Rescue offers CPR and first aid classes on Wednesday evenings; the next class begins Sept. 28. For the full class schedule and fees, check the district’s website here.