HumbleBeginnings
MickeyEisenberg,Resuscitate,2009Chapter6Location,Location,Location
“Ifyou’regoingtohaveacardiacarrest,whereshouldyoutryNOTtobe?TheobviouschoiceswouldbeLosAngeles,NewYorkCity,ChicagoandDetroit,citieswiththelowestpublishedsurvivalratesforcardiacarrestinvolvingVF—7%,5%,3%,1%respectively.”
HumbleBeginnings
• 2012IllinoisDepartmentofPublicHealthdata– 4%StateofIllinois:“pulse”athospitaldropoff– 2%Chicago:“pulse”athospitaldropoff
• MultipleFireDepartmentsreport<1%“survival”– “loadandgo”protocols– Attitude– “skillsfest”v.“resuscitation”
Gotta HaveaPlan
• HowtoengageChicagoFireDepartment?– Hesitancyrelatedtopreviouspublications– 4EMSMedicalDirectors:RegionXI– SeattleResuscitationAcademy
• IllinoisDepartmentofPublicHealth• Identifyingkeystakeholders
IllinoisHeartRescue
• Illinoisviedwith17otherStates• Septemberof2012• MedtronicFoundation:HeartRescuegrant– $2.5milliondollargrant– 5years(7years)–MorethandoubleneurologicallyintactOHCAsurvival
HeartRescueStates
Location,Location,Location
HighLevelTimeline
• Chicago’sapproach– 2011:IncidentCommandforCardiacArrestprotocol– 2012:SeattleResuscitationAcademy;CFDSimulationCenter;ILHRimplementation9/2012
– 2013:OEMCdispatchtraining;CFDcollectingCARES;RegionXISTEMIsystemofcare
– 2014:Dispatchprotocolchange;(new)TORprotocol– 2015:(new)ROSCandOHCAtransportprotocol– 2016:STEMICenterTargetedTemperatureManagementagreement/CardiacArrestSystemofCare
WhatWorked
• TelephoneAssistedCPR– OfficeofEmergencyMedicalCommunication(OEMC)– TremendousbumpinBCPR– CPRHeropins
WhatWorked
• ResuscitationAcademies– Statewideacademies– Freeeducation;con-ed hours;payitforward
• ChicagoFire– CFDIncidentCommandTraining– OHCArunreviews– Remediationtraining
WhatWorked
• IdentificationofHotSpotneighborhoodsandcommunities• Communityengagementv.outreach• Identificationofhealthdisparity– IncidenceofOHCA– IncidenceofBCPR– Incidenceofsurvival– IncidenceofCPC1-2
TakingittotheStreets
• Videosin6languages• Gotowherepeoplecongregate• Largescale/highvisibilitytrainings• Lowscaletrainings– Highcommitmenttopayitforward– Faithbasedorganizations– Grassrootcommunityorganizations– Schools– Parkdistricts
WhatWorked• Publicandprivatepartnerships• Implementsustainableinterventions
OngoingChallenges
• HospitalparticipationinCARES• Hospitalengagement– HospitalReportCards• Survivalgraphs• De-identifiedcomparisons
– IllinoisHospitalAssociation• Webinars
OnGoingChallenges
• Lauren’sLaw– EnactedinJuly2014– RequiresCPR/AEDeducationinIllinoishighschools
• The“honorsystem”– IllinoisStateBoardofEducation(ISBE)– Nocurrentwayofvalidatingcompliance
WhatWeAreProudOf
6.4 8 8.3 9.4 10.5
3.7 4.5 5.4 6.58.6
6.5 7.6 8.1 9 9.9
3.4 4.4 5.3 6.38.2
14.3
24.127.3
35.832.8
2529.2
35.3
44.1
37.1
0
5
10
15
20
25
30
35
40
45
50
2013 2014 2015 2016 Na/onal2016
OverallSurvival
OverallCPC
CardiacSurvival
CardiacCPC
Utstein
UtseinBystander
WhatWeAreProudOf
13
16.7
26.6 27
39.7
2.1 2.4 2.8 2.9 3.1
0
5
10
15
20
25
30
35
40
45
2013 2014 2015 2016 Na/onal2016
IllinoisBystanderCPR/AED2013-2016
Bystander(only)CPR
AEDuse
**EXCLUDES:NursinghomesandHCfacilities
StillMoreWorktoDo
2014 2016
OverallSurvival=9.9%Utstein Survival=35.4%
WhatWeAreProudOf
WhatDoesThisAllMean?
• Intermsoflivessaved• 2014:112neurologicallyintactlivesweresaved• 2016:219neurologicallyintactlivesweresaved• Anincreaseofover2livesperweek!• Whatmoremotivationdoyouneed?
WhereWeAreHeaded– Proposedlegislation• Requiringhospitalparticipationindatacollection• CommunityNeedsAssessment
– CHAMPIONS• Highschoolstudenthealthambassadors
– GlobalHealthAlliance
