What could be more important than saving a life?Quincy area first responders who saved lives at three separate cardiac arrests were honored Tuesday, Jan. 16, at the Quincy Fire Station.
Plumas County Public Health Agency Acting Director Andrew Woodruff presented first responders with a certificate during the recognition ceremony.
Sheriff Greg Hagwood gave receipients a Field Save pin. The pins are only awarded to those who have helped save a cardiac arrest victim who in turn can later walk out of a hospital in full recovery.
This is a departure from what has been counted and praised in the past, and what many other first responders are still doing. The Quincy area, as a HeartSafe Community, doesn’t count a save until an individual is prepared to leave a hospital under his or her own power. Those with extensive neurological damage don’t count under the program.
Sam Blesse, supervisor and paramedic with CareFlight Ground, said that it is still customary in Redding and in many areas to honor a first responder for keeping a patient alive at least until they reached the hospital. What happened after that point wasn’t considered as part of the first responder’s role.
In his opening remarks he provided some valuable local statistics. “Since we’ve made all these changes,” in 2016, 50 percent of the cardiac arrest victims were saved. This last calendar year 43 percent were saved. “The national rate is less than 9 percent,” he told those gathered.
Blesse said it was a lot to ask first responders when he recommended they stop what they had been trained to do and accept a new way of doing things. But to a person they did.
“I’d take this (group) over any paid department any day of the week,” he said, referring to all of the volunteer fire department first responders. Later he added that not only are they unpaid, but they respond in record time.
As the program wrapped up, some officials shared a few comments.
“I hear all good things,” Operations Manager Matt Brown told the group. “I always praise what’s going on here. It’s unique. It’s special.”
Ron Walter, executive director of CareFlight, said that it’s true that it takes a village to safe lives. “And you guys prove that.”
Walter went on to say that he’s seen proof that a community can pull together and accomplish its goal. Though he’s rarely seen it, he witnessed it here.
“I’ve known so many of you from the time I was a little kid,” Hagwood said, directing his comments to some of the longtime first responders. For those who come to the area “you will quickly realize we have something special,” he added about the dedication and willingness to change.
“I want to personally thank you,” Hagwood said. As a law enforcement officer with 30 years on the local force, he’s fully aware of the feeling of relief they all have when first responders arrive on seen.
Those honored with certificates and Field Save pins include CareFlight Ground Supervisor Sam Blesse, Charlie Reed, Assistant Quincy Fire Chief David Windle, Joanna Oliver, Quincy Fire Chief Robbie Cassou, Derek Gay, Tiffany Manchip, David Schmidt, LeeanneGoniea and Dony Sawchuck.
Those honored, but not present include Kevin Corriera, Chase Hume, Kevin Lancaster, John Gay, Eddy Mutch, Tom Higgins and Gerry Hendrick.
Coming off a 72-hour shift, Blesse said it had been a very busy four days. Ambulance calls for flu victims topped the list.
Blesse is a supervisor and paramedic with REMSA’s CareFlight Ground program. He’s also responsible for making Quincy and its surrounding communities, from Cromberg to Bucks Lake, part of the HeartSafe Community.
Born and raised in Quincy, Blesse spent much of his career in Redding. In 2014, he and his wife decided to return home. It was a brilliant decision; one that’s meant not only a better way of life for Blesse and his family, but for so many in the Quincy area.
In Redding there were “more cardiac arrests than I can count,” Blesse said as he enjoyed a cup of early morning coffee. And they “very rarely had saves.” In fact, there was an underlying assumption that a victim of a cardiac arrest would not live.
According to Blesse, the problem was that the first responders were busy with tubes and IVs and not the very basic skills required in CPR.
Settling into the area, Blesse said he saw a few cardiac arrests that weren’t run well. That’s when he decided he needed to change what he called the mindset of those responding.
What he did was to research the CARES program — Cardiac Arrest Registry to Enhance Survival.
What CARES does is gather data concerning cardiac arrests. And California is now at the point it can submit its data, Blesse explained.
“We have to gather the data to see results,” Blesse said about its importance. “The survival rate varies as much as 500 percent.”
As part of his research, Blesse realized that local first responders needed to change how they initially treated cardiac arrest victims. Through grants and donations, Automated External Defibrillators were placed in most county buildings, schools, at the college and in some businesses. “There’s a 60 percent survival rate with AEDs,” Blesse said.
Although it’s the intent to have individuals trained in the AEDs use and CPR where they are located, an AED is geared to assist anyone through the initial process of helping a cardiac arrest victim survive.
As well as placing AEDs in as many public places as possible, Blesse set about changing how Quincy area first responders deal immediately with a cardiac arrest victim.
Blesse convinced local first responders to concentrate on very basic lifesaving skills. “Never stop chest compressions,” he said. As medicine changes, so did this basic technique in favor of offering more advanced methods — tubes and IVs. “We never stop. We don’t even check pulses,” he said. Instead, the CO2 levels coming off the body are checked while compressions are continued.
Blesse had to apply to become a HeartSafe Community with its specific training demands. The Plumas County Public Health Agency became the certifying agency for the Quincy area’s efforts.
Blesse was able to immediately gain support of first responders at Plumas District Hospital and the Quincy Fire Department. Soon Meadow Valley, Bucks Lake, Greenhorn and Cromberg fire departments were signing on. Blesse is working on getting other hospitals and fire departments in Plumas County to change their mindsets, but even larger areas like Redding are slow to change.
HeartSafe Community application process
In meeting the HeartSafe Community criteria, Blesse pointed out there are conditions to be met, including how likely is someone to survive a sudden cardiac arrest due to rapid access to lifesaving treatment?
Through REMSA (Regional Emergency Medical Services Authority) in Reno, Plumas County received an enhanced 911 system. Now, when the Plumas County Sheriff’s Office Dispatch receives a 911 call concerning a possible cardiac arrest, they are able to immediately connect with medical staff that provides instruction and information on what to do before first responders arrive. REMSA continues that until the patient is transported to PDH or the decision has been reached for CareFlight to take the patient to Renown in Reno.
The process also calls for stepping up CPR training within the community so more individuals are prepared to act in the event of a suspected cardiac arrest.
Blesse said that as new AEDs were purchased, three or four of them went to deputies. “Police are proven lifesavers when trained and equipped with automated external defibrillators,” according to HeartSafe.
Another qualifying factor in becoming a HeartSafe Community is having EMS providers with ECG (heart monitoring) capability. The EMS provider also had to be trained in Advanced Cardiac Life Support.
“The Plumas County Public Health Agency and the American Heart Association aim to help the communities in Plumas County improve their cardiovascular health and increase the chances that anyone suffering a cardiovascular emergency will have the best possible chance for survival,” Blesse indicated in the application.
Through the HeartSafe community program, local communities must implement programs to strengthen what the AHA has called the chain of survival; improve cardiovascular health; and improve chances of survival from a sudden cardiac arrest.
The chain of survival includes the following steps.
Have early access to medical care. PDH is the first consideration, but someone on scene can determine if a flight to Renown is necessary.
Early CPR is needed. All first responders are trained in CPR and many are EMTs or paramedics. Blesse and others have also been providing opportunities for the public and special groups to be trained in CPR. “CPR, when properly administered, buys precious minutes until a defibrillator is available, according to information from HeartSafe Community literature.
Access to early defibrillation is essential, and since these are in so many public areas, as well as with fire departments and with some law enforcement members, there’s a good chance they are available when needed.
Blesse said that a first responder or someone trained in CPR can determine if the victim has a shockable heart rhythm. AEDs deliver an electric shock to the individual that can restore the heart’s normal rhythm. Getting that rhythm stabilized or restarted is essential. A shock should be administered within the first three to five minutes of an attack, according to HeartSafe Community information. Beyond that the rhythm might not be re-established or the patient might experience more permanent physical damage.
Early advanced care is another component. In the Quincy area, all first responder vehicles are staffed with trained EMS person.
HeartSafe Community also calls for a comprehensive, structured, integrated, multidisciplinary system of care. As indicated, if the personnel and equipment at PDH aren’t enough, Renown is fully equipped and ready.
There are six community population categories under HeartSafe Community. Blesse said he and others chose the population category from 5,001 to 30,000. This means there are a minimum of 850 heartbeats (points) required for the designation.
Heartbeats are determined as follows: 10 heartbeats are given for each CPR course with a minimum of six participants. And 10 heartbeats are awarded for each AED that is placed.
AEDs can be placed in public places including public, private and charter schools, health clubs, churches, businesses or business areas, locations where large groups routinely gather, senior centers and tourist attractions.
There’s also an opportunity to calculate a community’s heartbeats.
It’s mandatory that a lead organization, including fire, sheriff, ambulance or health agency, is designated to oversee efforts involving community organizations such as businesses, schools and churches and coordinating with EMS. For this the Quincy area was awarded 100 heartbeats.
Twenty-five heartbeats were awarded for having the advanced 911 system.
Fifty heartbeats were given because local dispatching has trained emergency medical dispatch personnel. This is possible through REMSA.
The Quincy area received 50 heartbeats for having an on-going community awareness campaign. This too was mandatory.
The Quincy area earned 160 heartbeats for increasing citizen responders by conducting CPR and AED trainings. It also depends on the community’s population. The goal is that 10 percent of the population is trained.
Local law enforcement has to have trained personnel and be equipped with AEDs. These units are to be dispatched as appropriate to scenes. The Quincy area earned 50 heartbeats.
Another 50 heartbeats were earned with fire first responders being trained and equipped with AEDs. This is a mandatory category.
Twenty heartbeats were earned because schools and municipal buildings have effective emergency response plans that include CPR and AED training.
A minimum of 100 mandatory heartbeats was required, and the Quincy area earned 230 for the public access defibrillation program with AEDs placed permanently in target areas.
A program has also been put in place to track AEDs in public locations and to reduce response times to early use. For this there was 50 heartbeats.
The Quincy area missed out on a possible 50 heartbeats because there isn’t an information management systems that links AEDs, citizens and sudden cardiac arrests.
But another 50 heartbeats were earned when advanced life support can be dispatched.
Because there aren’t ALS enhancements locally, Quincy lost 25 heartbeats.
Twenty-five heartbeats were picked up because there is a STEMI System in place, which decreased the time in diagnosing a heart attack and ensure therapy is provided within 90 minutes of someone calling 911.
Twenty-five points in each of the following areas were earned: Having an electronic data collection system, having cardiac arrest survival data and having stroke protocol in a pre-hospital setting.
And finally, another 50 heartbeats were earned for having an on-going process to evaluate and improve the chain of survival and overall cardiovascular health in the community.
Blesse said that “Seattle does it right,” in providing this program.
What the numbers mean
In 2016, Quincy had had four cardiac arrests and two of those individuals survived to leave the hospital and resume their lives.
Last year, there were seven incidents and three individuals recovered.
It’s difficult keeping trained personnel in top form to respond to a cardiac arrest, Blesse explained. There just aren’t that many incidents, so routine training is essential in keeping up those skills.
Cardiac arrest victim makes recovery in Reno hospital
The Quincy area first responders’ training and skills received praise from Northern California EMS, Inc. for making it possible for one local resident to recover from a cardiac arrest incident Oct. 30, 2017.
“Upon arrival to Renown Medical Center in Reno, the patient was awake and attempting to communicate with staff,” said Shawn Poore, a specialist with Nor-Cal EMS. “Less than 24 hours later, the patient was sitting up in bed, extubated and talking. He is expected to make a full recovery.”
It was Plumas County that took the lead when Nor-Cal EMS implemented a program called High Performance CPR in 2016, according to Poore.
They “were the first in all of the Nor-Cal EMS counties to have at least 80 percent of their EMS and fire personnel train in its use within the first five months of implementation,” Poore explained.
Based on the calendar year — January through December — the Quincy area had four confirmed field saves out of nine cardiac arrests. “This is the highest in all of the Nor-Cal EMS counties,” Poore said.
“This is made possible by your commitment to delivering high quality patient care, through continuing education, timely response and teamwork,” Poore noted.
“I would like to say ‘thank you’ for all of your hard work. It gives me great pride to work with, and for, such excellent caregivers,” he said.