Community can Help EMS System by Being Prepared

TODAY MARKS the beginning of a one-week celebration of EMS Week, an annual event that acknowledges the efforts of personnel who provide care in the Emergency Medical Services system.

Firefighters and ambulance personnel, including emergency medical technicians and paramedics, provide the first line of care to our communities, often in conditions of danger. Dispatchers take incoming 911 calls from the public (some under incredibly harrowing situations), providing an integral part of the initial response. Along with the front-line workers, emergency physicians, nurses and other hospital personnel are ready to save lives and reduce suffering.

The emergency care system, from 911 call to the hospital, provides access to care regardless of a patient's financial or insurance resources and represents a critical safety net for medical care in the community. Behind the scenes, and perhaps somewhat taken for granted, the men and women who serve in EMS provide immediate access to rescue and care 24 hours a day, rain or shine, weekday or weekend, holidays included.

EMS workers also will provide critical care in the opening hours and days of disaster situations, whether the scenario is an earthquake, bird flu epidemic, or toxic exposure. Their heroism and commitment to the community is unmistaken.

As important as the EMS system is, members of the community can add value and effectiveness to the system in numerous ways:

• Call 911 promptly: In the setting of a cardiac arrest, survival decreases by about 10 percent for every minute that a patient is without a pulse. Pick up a phone and start the system rolling! At times, family members will spend valuable minutes trying to wake up or revive an unconscious person or trying to contact a neighbor for help.

Time is so much of the essence in this situation that the first actions after recognizing a person is unresponsive is to pick up the phone.

• Learn CPR: Prompt provision of CPR (cardiopulmonary resuscitation) doubles the chance that a person will survive a cardiac arrest event. In a matter of a couple of hours, people can double the effectiveness of the EMS system.
• Consider obtaining an automated external defibrillator (AED) for your office, community center, place of worship or recreational facility: Public access to AEDs has led to many lives saved in airports, casinos and other locations.

An AED is easy to use, cannot hurt the patient or rescuer when simple precautions are taken, and can intervene in a cardiac arrest before EMS even gets there. Shaving minutes off in terms of providing a life-saving shock can mean 20-30 percent increase in survival.

AEDs aren't cheap, but costs have decreased and capable units are available for less than $2,000. Early defibrillation is by far the most cost-effective medical intervention for EMS. Earlier use of an AED and CPR by the public is even better.

• Recognize stroke symptoms and get help promptly: New advances in stroke care rely on timely recognition of symptoms and arrival at an emergency department. Clot-busting drugs must be given within three hours of onset of symptoms. After three hours, the risks outweigh the benefits of this treatment.

The long-term costs, both health-wise and financial, of stroke are monumental, and we have only a small window of opportunity to avoid the devastating effects of this disease.

• Be prepared for 911 responders: Identify your residence with a front-porch light at night, restrain your dogs, and have your medications or a list of them available for responders.
• Wear seat belts: We have an extensive and highly capable trauma system in our community. When I review trauma fatalities from auto accidents, one of the most noticeable trends is that so many do not wear seat belts.

In Contra Costa County alone, dozens of lives could be saved each year. New cars have airbag systems that markedly improve the safety in crashes, but their effects are minimized when seat belts aren't used. Our trauma system is powerless to help those whose injuries are fatal at the outset.

I'm proud of our EMS providers. In the decade I have been associated with them, I have noted high-quality care and what I believe is an ever-improving system. With a few easy steps, our community adds to the system. For details about CPR, contact 800-GIVE-CPR, the American Heart Association (510-904-4000) or our local EMS agency (www.cccems.org).

Barger is EMS medical director for the Contra Costa EMS agency.

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