Posted on 11/16/2018
Resuscitation Science Symposium

CHICAGO, IL--The American Heart Association Resuscitation Science Symposium kicked off last week in Chicago with an opening plenary session on dispatch-assisted CPR co-moderated by Joseph P. Ornato, MD, Virginia Commonwealth University, and Mary M. Newman, MS, Sudden Cardiac Arrest Foundation. The session included testimonials from two survivors and the family members who helped save their lives, plus a research presentation by Tom Rea, MD, MPH, University of Washington.

The session began with a video featuring a recording of the February 6, 2016, 911 call between Brendan Gould, then 16, and dispatcher Jeff Callaghan of Cencom 911 in Roundlake, IL. Brendan called 911 when his dad, Tom Gould, collapsed in their home in Barrington. “My dad and I were talking in my room when he slumped against the wall and fell to the floor,” said Brendan. “I didn’t know what was happening, but I knew I had to act quickly. I immediately picked up my phone, dialed 911 and explained the situation.”

Brendan’s calm demeanor and poise, supported by Jeff’s calm and reassuring instructions on providing “hands-only” CPR, may well have made the difference between life and death.

As Tom described in his remarks, “The 911 dispatcher calmly guided Brendan through CPR until a police officer arrived at our house, perhaps three minutes later. When you listen to the 911 call, you hear a calm teenager following directions in a challenging, emotional situation. Indeed, the dispatcher’s words speak volumes about Brendan that night: ‘I thought I was talking to an adult,’ Jeff said. ‘We don't get adults talking like he was. He was amazing, no panicking.’”

“On the night of my father’s cardiac arrest,” Brendan said, “I knew I had to focus on my role and not focus on any fear or doubts. I knew I had to follow instructions and trust in God to take control of the situation and the outcome, knowing whatever the outcome was, it was part of His plan.”

His sister Grace, then 12, was also part of the rescue team—she waited outside the house to flag down first responders. This proved to be essential—Officer Rita Kelly arrived quickly and took over CPR until the Barrington Fire Department arrived and provided defibrillation and advanced life support measures.

“Brendan, Grace and Jeff worked as a team to help save my life and I am grateful to all three,” said Tom.

Next, Rick and Jennifer Chap shared their story of survival, which occurred on February 27, 2012 in their home in Orlando. “I was in the kitchen,” Rick said. “One minute I was getting coffee and the next ‘Boom!’ dead on the floor.”

Working in her home office, Jen was alerted to the emergency by the family cat, Buddy, who was relentlessly meowing, scratching and jumping to get her attention. Fortunately, he did. Jen found Rick collapsed on kitchen floor gasping for air, and she immediately called 911. Kevin Seeley, a dispatcher from Orlando Fire Department 911 Communications, coached Jen in providing “hands-only” CPR.

“I had never met this person, but we instantly became a team that morning. Kevin was diagnostician, coach and my hero.” It had been 20 years since her CPR class, but she knew the new protocol was chest compressions only to the beat of Bee Gees’ “Stayin’ Alive.” Jen pushed hard and fast in the center of Rick’s chest, while Kevin encouraged her to count out loud. 

“I keep pushing,” she said. “I don’t give up, even when my own body seems to abandon my will. I push and push and push again. It seemed like forever, but I know it was merely minutes. And just when I think I can no longer be the heartbeat of my precious Rick, help arrives.”

With one shock of their AED Jen heard, “We got a heartbeat.” Rick is transported to Orlando Health’s Orlando Regional Medical Center, where he is put into therapeutic hypothermia. Three nights later Rick begins to regain consciousness. “The next morning, I get my first kiss,” she said. “And with that, life after SCA begins.”

"Dispatchers are the faceless heroes on the other end of the phone, who make the difference between life and death," said Jen. "Together, my dispatcher and I were Rick's heartbeat until help arrived."

“It’s now been six years,” said Rick. “We are incredibly grateful for all the ‘memories that may not have been’ were not for TCPR (telephone CPR) and a system that works.”

Following the personal testimonials, Dr. Tom Rea discussed the tremendous potential of dispatch-assisted CPR and his vision that more widespread implementation could lead to a 50 percent rate of bystander CPR by 2025.

Presently, only about half of the Public Safety Answering Points in the U.S. provide dispatch-assisted CPR instructions, but there is room for optimism, he said. “The medical establishment is now increasingly aware of the potential important role of telecommunicator CPR.” Last year, the American Heart Association issued a scientific statement calling the provision of Telephone-CPR (T-CPR) instruction for cardiac arrest a standard of care.[1] “The statement has been endorsed by the most important telecommunication and EMS organizations in the country,” he said. “In addition, legislative initiatives are underway in several states that would require TCPR training and performance.”

Presenting a diagram of the “slope of death,” Dr. Rea emphasized the vital importance of early CPR by bystanders, noting that providing CPR even a few minutes earlier can have a profound impact on survival. And, he said, TCPR increases the rates of bystander CPR. In King County, for example, the proportion of adults receiving CPR increased from 32% to 54% after the introduction of T-CPR.

“Telecommunicators should attempt to identify patients who are unresponsive with abnormal or no breathing and should provide T-CPR instructions,” he concluded. “A program of T-CPR can increase the rate of safe and effective lifesaving bystander CPR, which in turn can save more lives.”

SOURCE: Sudden Cardiac Arrest Foundation

[1] Emergency Medical Service Dispatch CPR Prearrival Instructions to Improve Survival from Out-of-Hospital Cardiac Arrest, A Scientific Statement from the American Heart Association.