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Wilmington leads country in cardiac arrest saves 

 
Wilmington area emergency medical personnel perform the new Pit Crew Process, which has drastically improved cardiac arrest survival rates in the area. Photo credit: Wilmington Fire Department.
Wilmington is leading the nation in cardiac arrest saves at double the national average thanks to a new training method developed by David Glendenning of New Hanover Regional Medical Center.

Glendenning and Wilmington Fire Department Master Firefighter and Training Officer Scott Rivenbark teamed up to provide life-saving training to emergency medical service personnel throughout the Southeast. 

“We started telling people what we were doing because we saw immediate improvements in our numbers,” Rivenbark said. “All that comes back to the faster we get someone on a cardiac arrest patient’s chest to start compressions, the better.”

The pair put on its first Cardiac Arrest Academy in 2012 at Cape Fear Community College, a three-day training where 500 people learned the “Pit Crew Process” and a new hypothermia protocol. Since then, they’ve hosted a Cardiovascular Symposium in Wilmington and traveled around the state to conduct other trainings.

“We named it the Pit Crew Process because, well, we’re in the South, and we like NASCAR, but it’s very similar to a pit crew’s response. When they come across the wall to work on a car, everybody knows their job,” Rivenbark said. “Before we get off the truck, we know exactly what everybody is going to do. There’s no time lost trying to figure out who’s going to do what when we get to the patient.”

According to Rivenbark, the three firefighters form a triangle around the patient with one starting on compressions immediately, one ready to work on the airway and one getting the AED setup. While the responder on compressions is working, the AED or airway responder will collect information from witnesses or family members.

Once the paramedics show up, they insert a cooled saline IV in the patient’s leg, which slows down the metabolism and reduces the amount of damage done by the lack of oxygen.

The process keeps all of the responders out of each others’ way, reduces the patient’s movement, increases the chance of survival, and helped the two administrations work better together. Rivenbark said one of the questions he’s asked most frequently is “How do the administrations get along?” He said there’s no fight for power between the fire department and the hospital, which allows them to make big changes that are best for the patient.

“To me, you have to put your ego aside. It doesn’t matter who’s got the most tax money. You have to do what’s best for the patient, and we have to work together to make the best outcome,” he said. 

In 2013, Wilmington’s survival rate was 19 percent. Rivenbark said 17 of the 19 people who went home last year survived with an optimal outcome, and only two went home with complications. This year, Wilmington’s rate is even better at 24 percent.

The training helped improve the survival rate, but the Wilmington Fire Department made it a priority to train each of the 219 firefighters as EMT Basics, which gives them a better understanding of the science behind cardiology. 

“The old adage about if it’s not broke don’t fix it? That’s not the case here,” Rivenbark said. “If we can do it better, we’re going to change it just to do it better.”