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Emergency Medicine
Race Against the Clock
 TEAMWORK: Collier County medical director Robert Tober and his EMS workers use a pit-crew approach to saving lives. [Photo: Nick Shirghio] |
Three years ago, Collier County medical director Robert Tober was home watching a NASCAR race when he had an epiphany. Noting the split-second choreography of the pit crew performing specialized tasks on a race car, Tober wondered if emergency medical responders could use the same approach to treating patients in cardiac arrest.
Shortly thereafter, Tober began testing a new “pit-crew” approach to the lifesaving process. The drill goes something like this: One provider delivers 200 uninterrupted chest compressions to a victim. After two minutes, a second provider standing by with a powerful mechanical compression device known as an Autopulse machine works with the first provider to place the machine on the patient. A third EMT works on airway management while a fourth individual, the team leader, focuses on the patient’s heart rhythm, defibrillation and the delivery of medication.
Today, Collier County’s annual save rate is 37% — compared to the national average of 6% to 10%. Dan Bowman, deputy chief of the Collier County EMS/Fire Department, says the quality of an EMS system coupled with bystander response are key factors that influence the outcome of resuscitation efforts. For example, some casinos in Las Vegas have attained survival rates of 50% to 70% through aggressive training programs for their security officers. Seattle touts a 30% save rate thanks to its programs. New York City, by contrast, struggles to maintain a level above 2%.
