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Take Heart Minnesota Planning Session

Take Heart Minnesota Planning Session. August 27, 2009. It began with a four-city demonstration project to dramatically improve survival from sudden cardiac arrest. Ben Jabs, 21 Student Anoka County, Minn. No history of heart problems One of the first survivors in THA.

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Take Heart Minnesota Planning Session

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  1. Take Heart Minnesota Planning Session August 27, 2009

  2. It began with a four-city demonstration project to dramatically improve survival from sudden cardiac arrest

  3. Ben Jabs, 21 Student Anoka County, Minn. No history of heart problems One of the first survivors in THA

  4. Sudden Cardiac Arrest: Summer 2006 • Treatment: • Bystander CPR from mother • BLS unable to defibrillate • Advanced CPR by EMS, including new devices to improve effectiveness of CPR and defibrillation • Level 1 Cardiac Arrest Center care • In-hospital cooling • Implantable defibrillator Future: Marketing career: graduate U of MN in 2009

  5. Minnesota Barbara and family, age 42 Cardiac Arrest October 2008, Sartell MN, survivor It has become a coalition of health care providers, educators, foundations, corporations, health departments, athletic associations, hospitals and survivor volunteers, and the list is growing.

  6. Take Heart America coordinates what the AHA recommends and what SCA victims need… • Bystander CPR • Quality CPR and new circulation enhancement devices by rescuers • AED • Improved drug delivery • After resuscitation: specialized care including cooling, blockage removal and implantable defibrillator

  7. Systems Based Approach • Rapid Response • Start CPR immediately • Rapid AED placement • High Quality CPR • ITD (ResQPOD) Survival • High Quality CPR • Advanced Airways • Intra-osseous drug delivery prn • ITD (ResQPOD) • Automated CPR (LUCAS) • Resuscitation Centers of Excellence • Hypothermia • 24/7 Revascularization • ICDs

  8. Intervention Outcome Relationships inTake Heart America

  9. Meet Samantha Take Heart America Save March 2009 Samantha: 18 yrs old 16 wks Pregnant VF Bystander CPR First responders: New CPR, ITD, AED ALS: Stabilize, Transport Resuscitation Center: Cooling, ICD

  10. Widespread CPR • Increase the percentage of SCA victims who receive effective bystander CPR • AHA’s CPR Anytime for Family & Friends • High school & college students & their families • Communities at large • Survivor network participation • St Cloud– all 9th graders/families trained CPR • CPR Goes to College

  11. More Rapid Response of Critical Elements • Widespread automatic external defibrillator (AED) deployment

  12. First Responders • Decrease EMS response times to SCAs • Immediate CPR • Rapid AED • Improve the Quality of pre-hospital CPR

  13. High Performance CPR • CPR before and after Shock • Devices, including ResQPOD, to more than double circulation during CPR • Control ventilation rate and volume • Hand position and Chest wall recoil All 911 responders (including police) carry and AED and ITD and have continuous retraining

  14. Increase the percentage of SCA victims who receive enhanced circulation management with an impedance threshold device (ResQPODTM).

  15. American Heart Association AHA Recommended Therapies for Increasing Circulation during adult CPR and Improving Resuscitation Rates CPR and Defibrillation and PAD Class I • Continuous chest compression for ALS; 30:2 BLS • Impedance Threshold Device (ITD) Class IIa • Epinephrine • Amiodarone • Mechanical CPR Devices • CPR before and after shock • full chest wall recoil Class IIb Indeterminate • Vasopression • Lidocaine • Atropine

  16. EMS • Improve the Quality of pre-hospital CPR • IO Drug Delivery • ITD • Automated CPR device

  17. LUCAS Device

  18. Why Level 1 Cardiac Arrest Centers? Mission/Care • Cooling – active protocol for rapid cooling • Cardiac Catheterization – 7/24 availability • Optimal care for re-arrests – New CPR, • ResQPOD + LUCAS • Critical Care – Boarded intensivists 7/24 • EPS and ICDs – 7/24 rhythm • management • Rehabilitation – PT/OT teams • CPR Training for family/friends – spread the word • Organ donation – shown to save additional lives

  19. Transformative technologies CPR Anytime Kit ITD Lay First Public Responder Intra - osseous Survival ICD b one injection Ý Hospital EMS Angiography AED T herapeutic h ypothermia Automated CPR device

  20. Minnesota Success in Phase 1 From 2006-2007 in the two MN sites all interventions implemented: • >12,000 people were trained in CPR, • bystander CPR rates increased from 21 to 27%, • 3 Level One Cardiac Arrest Centers were established, Survival in all patients following out-of-hospital cardiac arrest improved from 9.3% in 2005 (historical control) to 17% (P=0.03) in 2007. >50% of all patients admitted to the hospital, regardless of etiology, are discharged to home neurologically intact.

  21. Transformative technologies Bystander CPR ITD Lay First Public Responder Intra - osseous Survival ICD b one injection Ý Hospital EMS Angiography AED T herapeutic h ypothermia Automated CPR device

  22. Keeping Families Whole

  23. Transformative technologies Bystander CPR ITD Lay Public Intra - osseous Survival ICD b one injection Ý Hospital Angiography AED T herapeutic h ypothermia Automated CPR device

  24. Transformative technologies Bystander CPR ITD First Intra - osseous Survival ICD b one injection Ý EMS Angiography AED herapeutic T h ypothermia Automated CPR device

  25. <5 percent survival

  26. 30 percent survival

  27. Minnesota Challenge • Rural • Volunteer based initiative for 1st responders • Transport to Level 1 Resuscitation Centers • Suburban • Professional and volunteer 1st responders • Public access CPR and defibrillation • Urban • Professional EMS response • Public access CPR and defibrillation

  28. Take Heart Minnesota • Educational initiatives: • Proposal: The survivor network members want to lead this charge • This will require time, resources, direction and a strategy that needs to be developed • Standardize BLS and ALS response • First task and goal of THMn • This will require a state-wide effort, time, and resources • Data collection • Coordinate with local agencies and State Health Dept and CARES • Funding for Take Heart Minnesota • Make this a priority in 2009 grant applications • Time line: Plan for full deployment of BLS/ALS in 24 months throughout the state, starting in January 2009

  29. Celebrate the Saves

  30. With Gratitude to our Supporters & Friends

  31. Widespread CPR Training • State Fair; EMS Councils; Cub Foods • Public Education • HS and University programs • HS Athletic Assoc • Solidify Slide Set/Training Materials Progress to Date:Medtronic Corporate Grant: 100K Hired Executive Director August 3 2009 – Debbie Gillquist and Program Manager august 15, 2009 – Sarah WaldAdvisory Board • Rapid Response • Start CPR immediately • First responder protocol • Rapid AED placement • High Quality CPR • ITD (ResQPOD) • Working on distribution, packaging and training kits • Meeting with EMS Councils Survival • High Quality CPR • Advanced Airways • Intra-osseous drug delivery prn • ITD (ResQPOD) • Automated CPR (LUCAS) • Role of EMS RB • Role of Keith Wesley MD • Notification of First Responders • EMS Med Director Annual Mtg • MAA collaboration • Resuscitation Centers of Excellence (buy-in MHA) • Protocols under review • Hypothermia • 24/7 Revascularization • ICDs • Data: CARES, MDH • ResQTrial • First Cities/Counties

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