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April 8-14 is National Public Safety Telecommunicators Week, a chance to appreciate the unsung heroes who serve our communities answering and dispatching 911 calls.

2018 is especially significant as it marks the 50th anniversary of the first 911 call:

"[O]n November 8, 1967, House Congressional Resolution 361 was adopted: “The United States should have one uniform nationwide fire reporting telephone number…and police reporting telephone number."

"[I]n Haleyville, Alabama, on February 16, 1968, U.S. Rep. Tom Donald Fike Bevill became the first individual in the United States to answer a 911 emergency phone call. Rep. Bevill answered the call from inside the Haleyville Police Station – where this jurisdiction had unwittingly set up the first Public Safety Answering Point (PSAP)."

According to the National Emergency Number Association (NENA), “…an estimated 240 million calls are made to 911 in the U.S. each year. In many areas, 80% or more are from wireless devices.”

Calling 911: Best Practices

When you call 911, an EMS dispatcher with specialized training will answer the call. The dispatcher will ask for basic information, such as the type of emergency, location, the number and conditions of those who are ill or injured and what care is being provided. Answer the dispatcher’s questions as clearly as possible, and only hang up if directed to do so by the dispatcher.

NENA suggests following these best practices whenever calling 911:

When to call:  An emergency is any serious situation where a law enforcement officer, fire fighter or emergency medical help is needed right away. If you are unsure of whether your situation is an emergency, go ahead and call 911.

If you call 911 by mistake, do not hang up the phone: Stay on the line until you can tell the call-taker that you called by accident and there is no emergency. This saves the call-taker from having to call you back and confirm there is no emergency, or possibly sending police to check your address for an emergency.

Do your best to stay calm and answer all questions: The questions 911 call takers ask, no matter how irrelevant they seem, are important in helping get the first responders to you as fast as possible.

Know the location of the emergency: The wireless 911 caller must be aware that the 911 center that answers the call may not be the 911 center that services the area that the wireless caller is calling from. Look for landmarks, cross street signs and buildings. Know the name of the city or county you are in.

Teach your children how to call 911: Be sure they know what 911 is, how to dial from your home and cell phone and to trust the 911 call-taker. Make sure your child is physically able to reach at least one phone in your home. When calling 911 your child needs to know their name, parent’s name, telephone number and, most importantly, their address. Be sure all members of your household are aware that prank or harassing calls to 911 will be dealt with by local law enforcement agencies.

To all the 911 call-takers, thank you for all you do to help make our workplaces and communities safer.

AEDS

In August of 2017 the AHA announced new equipment requirements in order to teach CPR certification courses starting January 31, 2019. In a nutshell, in order to be compliant, an instructor needs to use an instrumented directive feedback device. The AHA defines these devices this way:

“An instrumented directive feedback device measures compression rate, depth, hand position, recoil, and chest compression fraction and provides real-time audio or visual feedback (or both) on these critical CPR skills. A feedback device can be integrated into a manikin or serve as an accessory to a manikin.”

In another article, it was more clearly stated the devices “must, at a minimum, measure and provide real-time audio and/or visual feedback on compression rate and depth, allowing students to self-correct or validate their skill performance immediately during training.”

WHAT DOES THIS MEAN TO CPR INSTRUCTORS?

So far the AHA has not given clear direction on the number of manikins required per instructor. Questions remain about whether or not an instructor can have one feedback device to use strictly for the skills test portion of training, or whether all practice performed in the class must be done on a feedback device. It has been touched upon in an FAQ to AHA Instructors:

“Q: What is the recommended ratio of feedback devices or manikins a Training Center must have in adult CPR training courses?

A: The recommended ratio of feedback devices is one per manikin (unless the device used is a manikin itself). Please note that any change to the ratio of manikins per students or Instructors in a course agenda could increase or decrease the length of the course. Use of feedback devices may actually reduce practice time as students will be able to self-correct as feedback is provided in real time.”

As of the publication of this article, the new requirement only affects Basic Life Support (BLS), Advanced Cardiovascular Life Support (ACLS), ACLS for Experienced Providers and Heartsaver® adult CPR training courses in the US and internationally. The new requirements do not include child and infant CPR certification at this time; however, it is anticipated those requirements will also be included over time.  

WHAT KIND OF DEVICES ARE REQUIRED?

Since certification classes require rescue breath training, instructors will still need to have a manikin which allows rescue breath training. There are many manikins on the market right now which have feedback devices already and would satisfy the requirement, from full-sized full trauma manikins to torso-only manikins and everything in between. Several manufacturers also offer feedback infant and child manikins as well.

External devices which either sit on top of the manikin’s sternum or can be placed under the “skin” of the manikin are also acceptable.

The AHA does not endorse any particular brand or type of device.

REASON FOR THE CHANGE

Back in 2015, when the new AHA guidelines for quality CPR were announced, the findings from the research which went into the changes also included information on the more accessible feedback devices being used in some training classes and the impact it had on skills retention. They found students trained with these devices were able to self-correct during training, which gave them longer periods of training at the correct rate and depth. This translated into better CPR performed in an emergency situation.

Drones and AEDs

Drones could soon be dropping off packages at customers' doors. But researchers in Sweden have drones in mind for a different, potentially lifesaving delivery: automated external defibrillators.

Using drones to carry AEDs to people who are in cardiac arrest could reduce the time between when patients go into cardiac arrest and when they receive the first shock from an AED, the researchers say.

The more time a person spends in cardiac arrest before being shocked with an AED, the lower the chance of survival. Shocking someone within three minutes gives them the best shot.

More than 350,000 cardiac arrests happen across the U.S. in places other than hospitals each year, according to the American Heart Association — and a person's chance of surviving is about 1 in 10. Drone-delivered AEDs beat ambulance trip times to the scenes of cardiac arrests, the researchers say in a letter published Tuesday in the Journal of the American Medical Association.

Dr. Michael Kurz, an associate professor of emergency medicine at the University of Alabama-Birmingham and an American Heart Association volunteer, sees the potential for AED-carrying drones to help save lives. He says this is the first time he has seen published data on the use of drones to deliver AEDs.

"This is a really neat, innovative method to combat a problem that we have been struggling with for decades," says Kurz. "It's the same reason we have public access to defibrillation. Airports, casinos, large public venues have AEDs on the wall because presumably, it would take a while for EMS to get there. This is, like, public-access defibrillation on steroids, where we just bring the defibrillator to you."

The researchers used drones to deliver AEDs to places in a rural area of Sweden where people had gone into cardiac arrest between 2006 and 2014, says Stockholm-based Andreas Claesson, the letter's lead author as well as a paramedic and registered nurse.

In each of the 18 flights that the drones made, they beat the ambulance time. The median reduction in response time was about 16 1/2 minutes. And the median time from dispatch to drone launch was three seconds, while it took emergency medical services a median time of three minutes to hit the road.

Even though there wouldn't necessarily be a medical professional on-site when a drone bearing an AED arrives, dispatchers could coach people through the process of using it.

Andreas Claesson/Courtesy of FlyPulse

Claesson says the idea to use drones to drop off AEDs came from an analysis that showed some people in rural Sweden had to wait about half an hour for EMS to arrive on the scene of an out-of-hospital cardiac arrest situation, leading to a survival rate was 0 percent, which he calls "catastrophic."

The team used geographic information system mapping to pinpoint locations that would be most effective for the test flights, Claesson says, and drafted predefined flight corridors that avoided flying over residents' homes until the drones were about to land in yards.

But more research needs to be done before we start seeing AED-laden drones touching down at cardiac arrest scenes. "We know nothing about bystander interaction," says Claesson.

One of his concerns: Sending an AED via drone means that there won't necessarily be a medical professional on-site.

The typical cardiac arrest patient is a 70-year-old man, he says, which means spouses — who may not be trained how to use an AED — would most likely be the ones using it in an emergency situation. But dispatchers could help coach people through the process of using an AED, Claesson says.

"We know that health care professional CPR is better than layman [CPR]. But we still believe that if we can deliver a defibrillator within five minutes, the proportion of people with shockable rhythms could be pretty high," Claesson says.

AEDs have simple enough instructions that allow just about anyone to figure out how to use them effectively, says Kurz, whose daughter has a congenital heart disease and is in fourth grade.

"They're fourth-graders, so there's a certain amount of corralling that has to occur, but yeah, they do great," Kurz says.He taught 400 of her classmates how to do CPR and use AEDs this year.

Are you as AED-capable as a fourth-grader? The Red Cross has a step-by-step guide to using an AED.

Claesson is planning a follow-up drone trial in Sweden next summer, when the local emergency medical services receive the most calls.

Kurz says future studies should go beyond analyzing response times and also examine patient survival rates.

"Now the idea of doing this in real life with real patients, when minutes matter, can be demonstrated."

Issued by the National Weather Service

SPECIAL WEATHER STATEMENT UNTIL 9AM EST WED ...ICY CONDITIONS ARE EXPECTED THROUGH THE MORNING COMMUTE... SNOW AND ICE MELT FROM YESTERDAY HAS REFROZE OVERNIGHT. AS A RESULT, SLIPPERY CONDITIONS ARE POSSIBLE, PRIMARILY ON UNTREATED SURFACES. USE EXTRA CAUTION ON THE MORNING COMMUTE. TEMPERATURES ARE EXPECTED TO RISE ABOVE FREEZING AGAIN LATER THIS MORNING IN ALL BUT THE HIGHEST ELEVATIONS OF NORTHWESTERN NEW JERSEY AND NORTHEASTERN PENNSYLVANIA.

hard and fast cpr

Do not be fooled by other websites claiming to give you “instant CPR certification online.” These so called classes may give you a card that states you took a “CPR class,” however they are not at all accredited and your employer or school will not accept this. The American Heart Association is the only accredited institution that is accepted by all healthcare institutions for CPR certification. All of our classes will give you a 2 year certification from the AHA, including our online classes, which require a skills test. Don't waste your time and money with non-AHA instructors!

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