Lethbridge Fire and Emergency Services (LFES) are using technology and education to solve industry-wide challenges in cardiac resuscitation. Using data from real-time events, LFES has worked with Alberta Health Services to created new protocols that are saving lives and garnering attention from agencies across North America.
More than 90 per cent of local cardiac arrest patients who are resuscitated by LFES are now arriving at the hospital with a pulse. Prior to implementing a new software called CaseReview, just 50 per cent of patients arrived with a pulse.
"This is such a good news story for our community," says Mike Humphrey, Emergency Medical Services Operations Officer with Lethbridge Fire and Emergency Services. "We know there are more people surviving cardiac events and having quicker, more successful recoveries because of the changes we've implemented. Seconds matter and our members have been working extremely hard to learn and improve. Our results speak to those efforts."
In 2020, LFES invested in a new cardiac monitoring system that included the CaseReview software. This online quality improvement program can record and playback serious events such as cardiac arrests. Using CaseReview, staff are looking at both patient and provider trends to create medical guidelines that will ensure the best outcomes.
"I want to commend Lethbridge emergency medical services for leading this innovative work through their implementation of the CaseReview technology," says Dr. Aaron Low, AHS South Zone Medical Director. "By identifying gaps and adjusting in real time while in the field, they have significantly improved the outcomes for patients in distress. This is a critical benefit for the individual in care and extends to their families as a result of their success."
One of the patient trends identified was that cardiac arrest patients that regain a pulse have extremely low blood pressure 50 per cent of the time. By addressing this condition quickly with medication, emergency medical teams are able to avoid a second cardiac arrest which improves chances of survival. This change has moved this treatment, which is usually used in the Intensive Care Unit or emergency room, and brought it to first responders.
One of the provider trends identified by playing back real-time events was that Cardiopulmonary Resuscitation (CPR) was sometimes stopped for a short time for other treatments, like starting an IV. After identifying those pauses, crews have changed their processes to ensure CPR is never stopped, for any reason.
"There are no other agencies using the software in the same way LFES is," says Humphrey. "Typically, an agency will use it to look at individual performances on a case-by-case basis. We are looking at our entire system's performance and making changes that benefit everyone. Because of our success, we've had a lot of interested from other Emergency Service departments across North America in what we are doing."
LFES have presented their new processes and results at several industry conferences including, the Paramedicine Across Canada Expo held in Saskatoon this past September.