There are few better places anywhere to have a cardiac arrest than Hennepin County. And that's no joke.
According to a national registry that tracks cardiac survival rates, your chances of surviving a cardiac arrest outside of a hospital are better in Hennepin County than almost anywhere else in the United States.
The reason, officials said, is that the county's emergency medical services system offers more highly trained responders, effective procedures and ready-to-use equipment in situations that can spell the difference between life and death.
"It's really a system of care, from public ambulance, first responder, hospitals, emergency departments -- everybody working together to improve survival," Dr. Charles Lick, medical director for Allina Medical Transportation, told the County Board last week.
A cardiac arrest isn't the same thing as a heart attack, which is caused by a blockage of blood flow but doesn't stop the heart. A cardiac arrest occurs when the heart stops beating, sometimes because of a heart attack, and blood flow to the brain is halted.
That's why it's important to respond quickly and effectively. Even under the best circumstances, the percentage of people who survive is low.
But the Cardiac Arrest Registry to Enhance Survival (CARES), a database program of the Centers for Disease Control and Prevention in Atlanta, found Hennepin County's record in 2010 better than all but five of the 50 cities and counties CARES tracked.
Of 462 people stricken last year in Hennepin County with cardiac arrest due to a heart problem, 16.5 percent survived. The comparable rate for all CARES jurisdictions, among 11,982 patients, was 10.4 percent.
Survival rates were better for cardiac arrest victims whose distress was witnessed by others, were shocked by a defibrillator and got immediate CPR. In Hennepin County, 49.4 percent of 89 such victims survived, compared with 31.8 percent of 1,631 patients in all CARES jurisdictions.
"That's just phenomenal," said Dr. Brian Mahoney the ambulance medical director at Hennepin County Medical Center.
Hennepin County has been working to improve emergency medical services at least since the 1980s, when the County Board formed an EMS council to develop coordinated responses and practices.
The survival rate for cardiac arrest in most communities is only 5 to 8 percent, and 50 years of CPR seminars hasn't changed that, Lick said.
So Hennepin County looked at improving the individual links in the "chain of survival." They include better dispatching service, more automated external defibrillators (which don't require training), and advanced care training for first responders, ambulances and hospitals.
For instance, paramedics now do an electrocardiogram test at the scene rather than at the hospital. If they pick up signs of a STEMI -- a more severe type of heart attack -- they can notify the hospital to be ready with the right treatment when the patient arrives.
The county also requires a two-paramedic team on ambulances, providing an extra brain and hands for emergencies, said Suzanne Gaines, who supervises the EMS unit in the county's Human Services and Public Health Department.
Last fall, the County Board required that all county employees get CPR training. The first of those sessions is scheduled for Wednesday.
The CARES report suggests that the county's efforts are paying off. Last year, Mahoney told commissioners, four bystanders were able to grab nearby automated external defibrillators and resuscitate cardiac arrest victims before they suffered brain damage.
Which is not to say there can't be improvement, Gaines said. More people in the community should be getting CPR training, she said, and more defibrillators should be installed.
Still, she said, "If you have a heart attack for whatever reason, it's nice to know you have a better chance here."
Kevin Duchschere • 612-673-4455