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East Pierce sees CPR survival rates rise with better training, improved medical oversight
Duane "Junior" Bratvold, 54, stood before the East Pierce Fire Commissioners just seven weeks after his heart stopped in the living room of his home. His family, including his wife Connie and their five-year-old grandson Liam, watched from audience as Bratvold thanked the firefighters and fire department for their efforts on May 3.
"I want to say, for myself and my family, I'm very grateful. It was a great Father's Day this year because of what you did for me," he said.
Bratvold, of Bonney Lake, said he remembers very little of what happened that day. He recalls complaining that his back and arm hurt and he was experiencing indigestion. After asking his wife to call 9-1-1, he collapsed.
"I woke up four days later in the hospital," he said. "It's hard to get your mind around what happened."
After Bratvold collapsed, the firefighters arrived to find him unconscious and lying in his wife's arms. Connie said that she was sure her husband was gone, but the first words from the firefighter were reassuring, "Don't give up yet. Let's see what we can do," she recalled one of the responders saying to her.
While East Pierce Battalion Chief Jeff Moore guided Connie, her daughter and grandson into another room, the firefighters began working on Bratvold with the precision of a pit crew. Just weeks earlier, they had undergone an intensive review of the department's high-performance CPR program, focused on coordinating patient care and improving patient survival.
"Firefighters and paramedics have quickly adopted the new performance standards" said Moore.
The combination of concentrated training, focusing on high-quality CPR, and improved medical oversight, have contributed to a significant jump in East Pierce patient survival from cardiac arrest. According to the department's EMS Division, survival rates for patients in a "shockable" cardiac arrest rhythm has climbed from an average of only 10% each year, to a 40 percent survival rate in 2011. Survival rates are based on the number of patients discharged from the hospital without serious complications.
The department has worked hard to achieve this success, according to Moore. Key elements include training the community in CPR, since bystander CPR doubles a victim's chance of survival. East Pierce Fire provides CPR training and certification to more than 2,000 people per year, including 1,500 eighth and 10th grade students, in the district. This effort has resulted in a 70 percent bystander CPR rate for witnessed collapses—one of the highest rates reported in the U.S. That means that seven out of every ten heart attack victims who collapse in public in the East Pierce jurisdiction receive CPR from a bystander.
CPR does not "bring someone back," but rather buys time by circulating oxygenated blood to the brain until the heart can be defibrillated, or "shocked" into to a normal rhythm that can sustain life.
The department supports schools and police departments throughout the district with CPR training and medical direction for automated external defibrillator (AED) programs. East Pierce hopes to generate increased interest in placing AEDs in businesses, churches and anywhere else people gather.
Additionally, the department has implemented new medical procedures, such as "field hypothermia" or cooling treatment to improve CPR patient survival. Cooling patients whose hearts are defibrillated and restarted helps to minimize the chance of brain damage in survivors.
These changes, along with close medical oversight by the department's EMS physician and the intensive review sessions for crews involved in each CPR case, have helped improve patient survival.
"The more I learn about this, it's phenomenal that I made it from the house to the hospital," Bratvold said. "I am very blessed that they had the training they did."
He reports that he survived one of the deadliest types of cardiac arrests with no damage to his heart. Except for a cracked sternum from the chest compressions, he is recovering nicely.
"I'm back to 'honey-do's' now," he said.
Bratvold wanted to tell his story to the fire commissioners and let them know how grateful he and his family are for the firefighters who responded to his emergency.
"What they did for my family was above and beyond the call of duty. I used to chuckle about the saying on the side of the ambulance—'Where Compassion and Action Meet.' I tell you, without a doubt, I totally understand that now."