A Heart Month Question: Where Can You Fit In The Chain Of Survival?

By John Voket

This is the second in a three-part series about improving and maintaining cardiovascular health during American Heart Month.

Luckily, all the links in the so-called “chain of survival” held strong for Sandy Hook resident Jacques Lombardo last November 11, and he is living proof of the critical effectiveness of that chain.

Bob Virgalla, a volunteer with the Newtown Ambulance Corps, says the emergency the Lombardo family experienced in late 2011 is a potent success story regarding the Chain of Survival. The family noted something was wrong — severe chest pain — and called 911.

Sandy Hook Fire EMS Captain Karin Halstead was first to respond and performed what would be life-saving CPR after discovering Mr Lombardo had no pulse and was not breathing.

Working side by side with her father, Sandy Hook Chief Bill Halstead, and firefighter Richard “Archie” Paloian, they initiated vital intervention until Mr Virgalla, Newtown Ambulance EMT Josh Barrows and paramedic Jason Ucci quickly provided advanced life support while transporting the victim to Danbury Hospital.

Sandy Hook Fire & Rescue members Anthony Carpenter, Anthony Capozziello, Stephen Clark, Brian Engelke, Al Lescrynski, George Lockwood, Jr, Robert Sibley, Karl Sieling, and Steven Stohl also responded to the call to lend assistance.

Once Mr Lombardo rolled into the Emergency Room in Danbury, he began receiving the integrated post-cardiac arrest care that helped fast track his return home after an initial period of observation and recovery. And he was feeling well enough to turn out and thank all of those responders at a testimonial just three weeks later at the Sandy Hook fire headquarters.

But the fact remains — if the series of responses that began with an immediate call for help once symptoms presented was not set in motion immediately, Mr Lombardo’s heart attack may have been fatal.

Play A Role

Newtown Health District Director Donna Culbert told The Newtown Bee this week, as part of her outreach during February — American Heart Month — there are many ways Newtown residents, business people, or even visitors can play an important role in the Chain of Survival. It can be as basic as recognizing a life-threatening medical emergency and calling 911.

“This is truly one of the most important steps — and should be the first link in the chain,” Ms Culbert said. “Equally important to saving a life is performing CPR on a cardiac arrest victim, as well as utilizing a defibrillator on that victim if one is available or in proximity, similar to the ones here at the municipal center and a growing number of public and private buildings in town.”.

She said the American Heart Association best describes the five links that have been documented to increase the chance of survival and recovery for heart attack victims, as well as stroke and other emergencies:

 Immediate recognition of cardiac arrest and activation of the emergency response system involves the ability of bystanders to recognize the symptoms of cardiac arrest and call 911 immediately. It also means that EMS dispatchers are equipped with instructions for the caller and can get an advanced life support response vehicle to the scene quickly, she said.

“Early cardiopulmonary resuscitation [CPR] with an emphasis on chest compressions or CPR, when properly administered, buys precious minutes until a defibrillator is available,” the heath official said. “Public knowledge and awareness must be increased so that those trained in CPR will actually use it when it is needed.”

Early defibrillation — the delivery of an electric shock to restore the heart’s normal rhythm — is another critical link in the chain of survival if it is required.

Then, effective advanced life support is required. Advanced care is delivered by a response vehicle staffed by advanced life support personnel (EMT-intermediates and/or paramedics). Advanced care is a way of providing many of the emergency room procedures in the field in a timely manner, thereby increasing the chances of survival for a victim.

Integrated Care

Integrated post-cardiac arrest care is next in the chain.

“These are technical interventions — known as therapeutic hypothermia, hemodynamic and ventilation optimization, immediate coronary reperfusion with percutaneous coronary intervention, glycemic control, neurologic care — which are administered by trained professionals to help the cardiac arrest victim,” Ms Culbert said. “They will improve the chances of survival, but the system has to be put into motion as quickly as possible to get relevant benefits from these interventions.”

According to Mr Virgalla, the public information officer (PIO) for the Newtown Ambulance Corps, the American Heart Association advises that cardiac arrests are more common than you think, and they can happen to anyone at any time.

Nearly 300,000 out-of-hospital sudden cardiac arrests occur annually, and 80 percent of cardiac arrests occur at home. Many victims appear healthy with no known heart disease or other risk factors.

The local ambulance PIO also stressed that “time is tissue.”

“Time lost in failing to respond or having a slowed response costs important tissue; damage is done to heart tissue and brain tissue,” Mr Virgalla said. “Every second counts.”

The Newtown Health District and Newtown Ambulance volunteers want to reassure residents not to be afraid, embarrassed, or hesitant to call 911 even if they suspect the symptoms may be from a stress attack, food poisoning, or some type of muscle pull or strain.

“Your action can only help, and emergency responders would be much happier determining discomfort is simple indigestion than having to respond to try and revive a victim whose heart has stopped.

“If you see an unresponsive adult who is not breathing or not breathing normally, call 911 and push hard and fast on the center of the chest,” Ms Culbert advises.

Who Can You Save?

Mr Virgalla said Newtown Ambulance volunteers and the town’s paramedics from Danbury Ambulance Service are there to help with emergency care and transport.

“But we can’t help unless you put the system in motion,” he said.

Also critically important, according to the local responder: when suspecting a cardiac or respiratory emergency, do not drive your loved one to the hospital.

“Don’t get in the car; please call 911,” he stressed. “The responders want to come to your home or business to help, they do not want to end up on Route 84 dealing with an emergency with important response time having lapsed.”

Ideally, he advises, residents should have medical information or a health history available in writing, along with an up-to-date list of all medications, allergies, and details on recent medical procedures within easy reach for responders.

“During an emergency it may be difficult to relate this important information,” Mr Virgalla added.

Newtown Ambulance is also reaching out to the community to help fortify their civilian backup for medical emergencies by offering an upcoming CPR and First Aid training session. Look to The Newtown Bee for information as soon as the classes are scheduled.

One of the most important things to remember is the life you save with CPR is mostly likely to be a loved one, Ms Culbert said.

According to the Heart Association:

*Four out of five cardiac arrests happen at home.

*Statistically speaking, if called on to administer CPR in an emergency, the life you save is likely to be someone at home: a child, a spouse, a parent, or a friend.

*Failure to act in a cardiac emergency can lead to unnecessary deaths.

*Effective bystander CPR provided immediately after sudden cardiac arrest can double or triple a victim’s chance of survival, but only 32 percent of cardiac arrest victims get CPR from a bystander.

*Sadly, less than eight out of 100 people who suffer cardiac arrest outside the hospital survive.

Residents are encouraged to prepare themselves to act in an emergency by viewing the hands-only CPR instructional video (handsonlycpr.org) available free at the American Heart Association’s website.