Between the Lines

Between the Lines by David Lias We start this column with a not-so-pleasant scenario: you or a loved one, out of the blue, suffers sudden cardiac arrest.

The natural response is to call 911 to dispatch emergency medical technicians as quickly as possible.

What many people don�t realize, however, is that 911 sets in motion a �chain of survival.�

That chain has four links:

1. Calling 911 and dispatching emergency crews.

2. Early CPR provided on scene by trained bystanders.

3. Early defibrillation.

4. Early advanced care provided in an ambulance and emergency room.

We are fortunate in the Vermillion community to have state-of-the-art medical facilities and emergency response capabilities.

The recent acquisition of a new ambulance and our community�s highly trained technicians help insure that if any of us need medical care, help will come quickly.

What�s rather ironic, however, is that in spite of the best local efforts, a vital link in the chain of survival is missing.

The Vermillion community and Clay County is lagging behind in the third link that calls for early defibrillation.

Anthony Burbach, grant program manager of the Vermillion/Clay County Ambulance Association, hopes to change that.

His goal is to round up enough funding to purchase 10 Automatic External Defibrillators (AEDs).

The portable devices could be carried in city, county and USD emergency vehicles. The accessibility of AEDs to the public will improve the cardiac arrest survival rates in Vermillion and the Clay County area.

Sudden cardiac arrest strikes without warning, and effects the lives of about 225,000 Americans each year. Many victims are leading healthy, active lives when they collapse due to an electrical malfunction in the heart.

Typically, fewer than 5 percent survive. However, as many as 50 percent or more of these victims could survive and resume normal lives if they were treated quickly enough with a defibrillator.

According to data gathered by Burbach, an estimated 23,000 people in South Dakota die every year from sudden cardiac arrest.

When someone collapses from sudden cardiac arrest, the person must receive rapid defibrillation with minutes or they will die. In Clay County, 19 of every 20 victims do not survive.

That�s certainly not acceptable.

�We need to create a completely new ?culture of response� among our citizens,� according to Burbach. �People need to understand the importance of acting quickly in order for someone to survive.

�Calling 911 immediately, starting CPR, and using and AED are the first three links in the chain of survival we can all initiate to help save a life,� he said. �Early access to advanced care by an ambulance is the final crucial link in the chain.�

During times when local government budgets are lean, it�s not easy to scrape up the money needed to purchase 10 AEDs. They each cost nearly $2,400. Add training, maintenance, equipment and other costs to that total, and the final bill to purchase 10 AEDs totals just over $25,000.

Burbach has done some additional math, however. It is estimated that the average annual incidence of sudden cardiac arrest is about one case per 1,000 adults. It is also estimated that approximately 60 percent of cardiac arrests are witnessed by someone, which sets the chain of survival in motion.

Assuming that Vermillion ensures that bystander CPR is provided in at least half of all cases and that the �call to shock� time is five minutes or less in 90 percent of cases, the community can expect an estimated 45 percent of victims in witnessed ventricular fibrillation to survive and leave the hospital.

By conservative estimates, they will live an average of three more years.

To determine the cost per life year gained, the cost of the program was divided by the number of lives saved times the number of years survival.

Vermillion�s department and community cost per life gained equals $25,043 divided by 4.1 life years gained.

It�s that life years gained that the community must focus on. Yes, the AEDs will cost about $25,000. But their cost per life year gained in our local community is about $6,100.

In other words, the benefits AEDs will provide are well worth their cost.

Since May, Burbach has been busy drumming up financial support for the AEDs. He is hopes to collect grants from local clubs and organizations, and no doubt would welcome individual contributions as well.

We urge the Vermillion community to respond favorably to Burbach�s efforts � which, when successful, will strengthen our city�s health.

It�s time to fix that missing link in the chain of survival.

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