OPINION: It takes a system to save a life

Published in Anchorage Daily News

By Doug Schrage and Michael Levy

Sudden cardiac death (SCD) was cast into the spotlight when 23 million viewers saw Damar Hamlin collapse on a football field followed by his successful resuscitation due to immediate bystander CPR and the use of an automated external defibrillator (AED). Since then, we have seen him on TV showing his full recovery, highlighted by a return to the NFL. SCD is the largest cause of natural death in the U.S., affecting over 325,000 annually. It is the result of the heart acutely failing to pump blood due to a heart attack or other problem. Although more prevalent in older age groups, it can occur at any age. As in the case of Hamlin, survival with a good neurological outcome is possible and even likely if a community has established a system of care for SCD: the chain of survival. We want to share the good news about the results of the cardiac arrest chain of survival in Anchorage.

Anchorage residents and visitors should be comforted to know that the survival rate in our community is among the highest in the nation. For those in 2022 who suffered an SCD in Anchorage due to a “shockable rhythm” and received bystander CPR, about 60% were discharged from local hospitals with good neurological function. Nationally, the survival rate is 34% and for Alaska it is 47% overall. Statistics are not as compelling as the fact that this represents 42 fellow citizens who are now intact survivors of SCD.

Anchorage’s success in treating SCD is not a miracle, nor is it due to luck. These are the results of a multiyear focus on improving the outcomes of patients whose hearts have stopped beating by building a system of care for out-of-hospital cardiac arrest. It starts with residents who know CPR or will perform hands-only CPR when instructed to by our AFD 911 telecommunicators (dispatchers). In fact, more than 80% of callers who have never been trained in hands-only CPR do so in the moment with the skilled instructions of our telecommunicators. The next link in this chain includes APD officers who often arrive first at the scene of SCD, bringing with them CPR skills and an AED. Highly trained AFD EMTs and paramedics are the next link, providing advanced resuscitation skills and mobile critical care transport of successfully resuscitated patients. These early survivors arrive at our local hospitals and receive state-of-the-art care along with the necessary interventions to sustain recovery from the event. When we add to this any post-hospital care and support for the survivor and his or her family, we have described our system of care for SCD.

The chain of survival and the system of care of SCD in Anchorage is strong, and for that we should be thankful and a bit proud. However, we must continue to improve each day of every year because, literally, lives hang in the balance. What can you do?

1. If you encounter someone who may be in cardiac arrest (someone suffers sudden collapse and is not awake or alert and not breathing normally) dial 911, summon help, have someone find and AED and immediately begin CPR. CPR at the earliest possible time after cardiac arrest is a critical intervention to save a life. It is remarkably easy to do, and hands-only CPR has been shown to be very effective. Automatic AEDs are available for public access in various locations: you must not hesitate to use one if you find someone in cardiac arrest (they are self-explanatory with visual and voice prompts; you cannot hurt someone with it when you follow the prompts)

2. Learn CPR. It is easy to learn how to save a life. Call the local American Heart Association or American Red Cross affiliates to find out about local classes.

3. Become a citizen responder! Please download PulsePoint (https://www.pulsepoint.org/), a free app that can notify citizen responders of nearby cardiac arrests.

4. Make sure that there is a publicly accessible AED in your place of work, place of worship or other public areas you frequent.

5. Talk to your Alaska legislator. Alaska is one of only a few states in the U.S. that does not have some form of required CPR and AED competency by the end of secondary school!

Learn more about SCD by visiting the Sudden Cardiac Arrest Foundation website (https://www.sca-aware.org/).

Remember, it takes a system to save a life and you can be — should be — a part.

Doug Schrage is fire chief of the Anchorage Fire Department.

Dr. Michael Levy is the medical director of the Anchorage Fire Department and chief medical officer for Anchorage areawide EMS.