Putnam County/ Cookeville Cardiac Arrest Survival:

The following paragraphs contain information about the Cardiac Arrest Survival Rates in the Putnam County/Cookeville community. Statistics are cited. Many of the components of the program are outlined in this document.

There is no single component that has made this program a success. It is a broad based, community wide effort to provide excellent medical care. As a result of this, the community has experienced tremendous success in Cardiac Arrest Survival.

The majority of the saves have been achieved by Professional Responders (Paramedic, EMT, Firefighters, etc.) Some of the arrests have occurred after the responders arrived.

We noted an increased number of saves with the addition of biphasic defibrillators.

AED and Cardiac Arrest Survival Points:

•  Long evolution and work in progress

• Vision of Dr. Chuck Womack, Dr. Sullivan Smith, Dr, Alex Case, Commitment of Cookeville Regional, Putnam County EMS, Randy Porter Director; Cookeville Fire, Gene Schmid, Chief.
• Community Cardiac Care being addressed on a broad basis
• Advanced prehospital care
• Mostly double Paramedic ambulances, well equipped and supplied to deliver advanced care
• Multiple first responders, some trained and equipped to Paramedic level. Non competitive environment, all department work together with the only goal being to deliver care in the quickest and best fashion.
• CPR/AED first responders, police, sheriff, fire, administrative personnel
• Public Access AED
• Government buildings initially
• Now moving to churches, businesses, fitness centers, and homes

•  Coordination

• Putnam County 911
• Receives all initial 911 calls
• Putnam 911 has enhanced 911 system
• Putnam 911 dispatches EMS, Cookeville Fire and all first responders, in-house, no call transfer or time wasted
• Putnam EMS and Cookeville Fire are dispatched on their frequencies. All other AED responders including police, administrative, sheriff personnel are dispatched by setting off one voice pager tone.
• AED responders are dispatched on all potential cardiac arrest, seizure and obstructed airway calls.

•  Medical Direction

• Dr. Sullivan Smith is the Medical Director and Dr. Alex Case is the Assistant Medical Director for Putnam EMS and all local First Responder and AED Responder Agencies. All operate under common Standing Orders.
• Almost all care is rendered by Standing Orders. Responders seldom need to contact Medical Control prior to any treatment that is within their Scope of Practice.
• Dr. Sullivan Smith and Dr. Charles Womack are the Medical Director for the majority of devices in the community.
• Dr. Sullivan Smith and Dr. Alex Case respond to scenes when available and carry defibrillators.
• Cookeville Regional Medical Center offers advanced hospital care from Emergency Department through Cardio-thoracic surgery
• Cardiology
• Cardiac Surgery
• Regional Referral Center

•  AED Purchases

• 1 st AED purchased by Putnam EMS to be carried on ambulance mid 90's
• Cookeville Regional Medical Center purchases first 10 public access AED in county, distributed to first responders and some public buildings, mid nineties
• Cookeville purchased enough AED to equip all city public buildings, all city fire trucks and several city police cars. Late nineties
• Putnam County purchased AED for all county public buildings. All ambulances have been equipped for years. A few sheriffs' department cars are equipped. All schools have AEDs placed. 2003-04
• A few businesses have AED prior to 2003
• Began encouraging local businesses, churches and organizations to purchase AEDs 2003
• Currently over 130 devices in Putnam County
• Government owned: 65+
• School/Education: 25+
• Business/Office/Factory: 15+
• Church: 20+
• Residence/Community: 4+
• These numbers are ever changing

•  2002, Putnam County EMS and Cookeville Fire Department switched from monophasic defibrillators to Zoll M Series Biphasic defibrillators.

•  2003, Cookeville received 2 AED on State RAED Grant. Putnam County received 1.

•  2003, Mended Hearts (A post bypass support group) started donating devices to 5 local churches.

•  2003, Cookeville Regional Medical Center and Zoll began a program to lend and AED. The Education Department at the hospital has two devices that can be checked out for family reunions or any public gathering.

•  2004, Putnam County has been notified that it will receive more AED on the RAED Grant.

•  Training:

• Trained First Responders and CPR/AED responders. mid to late nineties
• Cookeville received American Heart Association “Safe City Award” 2003
• Program started by Putnam EMS and Cookeville Fire to train all sophomores in county to Heart saver/AED level. Program intends to train all sophomores each year and re certify students as seniors. This program was begun in 2004.
• Offers free training of 24 people to any business, church or organization that purchases AED
• More than 1400 people have been trained to Heart saver/AED level Since November 2003

•  AED Plus responders

• 2004, currently developing a program to train police and other responders using Heart saver/AED standards. In addition these responders will have 16-24 hours training to deal with basic emergencies such as bleeding, falls, seizures, fractures, etc. Limited amount of medical equipment with responders.
• Equipment has been obtained through a Grant

•  First Lay person save

• December 2003
• University fitness Center
• Revived a 46-year-old male with 2 shocks prior to any first responder.
• Pulse restored prior to first arriving responder.

•  Funding

• Putnam County
• Cookeville
• Local Hospital
• Donations of individuals and businesses
• Grants
• Aggressively negotiated pricing on devices

•  Cardiac Arrest Survival:

• Data Analyzed using internationally recognized Utstein Standards
• Utstein criteria means that the arrest was witnessed by someone and help was summoned immediately, the patient was in ventricular fibrillation on arrival of the first responder and the arrest was caused by a cardiac event.
• July 2002-June 2003 first year stats kept locally
• Countywide: 13 survivable arrests. 7 regained a pulse, 6 discharged alive and well from hospital for 46.2% survival rate
• Cookeville: 6 survivable arrests. 4 regained a pulse, 3 discharged alive and well from hospital for 50% survival rate
• Rural Putnam County: 7 survivable arrests. 3 regained a pulse and 3 were discharged alive and well from hospital for 42.9% survivable rate
• July 2003-June 2004
• Countywide: 13 survivable arrests. 7 regained a pulse, 6 discharged alive and well from hospital for 46.2% survival rate
• Cookeville: 6 survivable arrests. 4 regained a pulse, 3 discharged alive and well from hospital for 50% survival rate
• Rural Putnam County: 7 survivable arrests. 3 regained a pulse and 3 were discharged alive and well from hospital for 42.9% survivable rate