Should more fire departments use advanced life support?

7:39 PM, Jul 19, 2013   |    comments
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GRAND HAVEN TOWNSHIP, Mich. (WZZM) -- It's a 911 call that rarely has a happy ending; if you suffer from a cardiac arrest, your chances of survival are less than 10%.

However, a local fire department believes it has found a key to dramatically increasing your chance of survival. WZZM 13 looked into whether more fire departments should use the same equipment.

Seconds matter, when trying to save a man with no pulse or blood pressure.

"From a legal standpoint, I was pretty much dead when I hit the floor," says Carl Smith, a cardiac arrest victim.

One year later, Smith is sitting and talking to WZZM 13 about the experience. He considers himself fortunate because of where it happened; at a Walmart but more importantly, in Grand Haven Township instead of Spring Lake Township where he lives.

"Saved my life, absolutely," says Smith. "If I was going to bet, I would say I had a lot better chance of surviving this then I would in Spring Lake."

Smith received what's known as Advanced Life Support or ALS from Grand Haven Township firefighters. Other fire departments rely on ambulances for the same equipment and expertise.

"Ambulances are few and far between and they're responding to calls as quickly as they can, but many times they're coming from a remote area," says Tom Gerencer, Fire Chief of Grand Haven Township Fire Department.

ALS is the highest of three levels of life support: the first level is Medical First Responder, which requires 60 hours of training and includes CPR and defibrillator use. The second level is Basic EMT, which requires at least 120 hours of training. ALS has a 1,200 hour minimum and once a person completes the training, they're considered a licensed paramedic who is able to use high-tech diagnostic systems and administer IVs.

"If someone does go into cardiac arrest we're able to give the proper medications," says Gerencer.

Before using ALS, Grand Haven Township had an average save rate of 14%. After the switch to ALS in 2008, the numbers jumped to 43% saved. In real terms, that was six people's lives.

"We would not have saved six people out of that 15, we might have been lucky to get one or two," says Gerencer.

"I think it's critical as part of a tiered system," says Dr. Jim Walters, Medical Director of the Ottawa County Medical Control Board. Walters, who oversees emergency procedures in Ottawa County, says ALS has less impact on cardiac arrest survival than other immediate responses.

"The key is early CPR early defibrillation," says Walters. "If the patient has survived because of CPR and early defibrillation, the next step is the medications that are provided by the ALS services."

For some fire departments, the cost of ALS is an issue. Each unit runs about $35,000, not counting dollars spent to train paramedics.

"Financially, for municipalities it can be a struggle for that extra push," says Brian Sipe, Deputy Chief with the Spring Lake Township Fire Department.

Spring Lake Township did not save a single person from cardiac arrest between 2008 and 2011. Then in 2012 it upgraded to the second highest level of life support, Basic EMT, and the same year it saved a life.

WZZM 13 asked Sipe what the numbers show about higher levels of life support. "What it says for us is the system is working, we've been able to add more tools to our toolbox," says Sipe.

WZZM 13 asked Sipe if Spring Lake Township residents would be better served with Advanced Life Support. "I think that's one of those things that will be continued to be debated," says Sipe.

"If the people in the township are made aware of this, it certainly may sway any decision they may have," says Smith.

Smith is now looking forward to his 70th birthday next month. He says he's also grateful to the Walmart employee who immediately began CPR on him.

WZZM 13 wants to make it clear that medical experts say early CPR and defibrillation are the key to surviving cardiac arrest.
However, Grand Haven Township's success could have other fire departments looking into a higher level of response.

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