By Jeff Clawson, M.D.
Who’s often first on the scene in an emergency? Law enforcement.
Police officers, sheriff’s deputies, highway patrol, and specialty police (such as search and rescue and SWAT) are often on scene before firefighters and EMTs/Paramedics arrive for reasons including proximity, safety, and availability. So, it only makes sense that these same people carry tools proven effective in medical emergencies, particularly automated external defibrillators (AEDs) to give a second chance to patients of sudden cardiac arrest (SCA).
Arriving with an AED, however, is actually down the list of actions necessary to success. Strengthening the Chain of Survival requires more than purchasing AEDs, placing them in squad cars, and training officers how to use them. After all, would the Lone Ranger prove effective in uncharted territory without his astute companion Tonto providing direction?
As the Academy – and its founder Jeff Clawson, M.D., has long asserted: dispatch is a critical component in an AED program. It’s essential that response agencies coordinate their protocols, and continue to fine-tune procedures once officers with AEDs are being deployed. Survival rates suffer without coordinated response to cardiac emergency calls and timely hand-off to medical professionals who can provide advanced life support.
EMDs trained and certified in the use of the Medical Priority Dispatch System (MPDS) are an essential first step to better ensure efficient and rapid deployment of AED-equipped officers. Tied to that step is the working relationship between the communication center and law enforcement field response. EMDs are vital partners in managing the types of calls that AED-equipped officers respond to, and, at a minimum, dispatch protocols should be specific and clearly identify medical problems that will trigger an AED response from an agency.
This was an issue that led to the Academy’s development of the Cardiac Arrest Quotient (CAQ), as described in the accompanying article. The CAQ is the number of SCAs found at scene within a particular determinant descriptor divided by the total number of responses generated by that code. The formula delineated stronger indicators, heralded the addition of several new, richer CAQs, and stimulated continuing research into establishing associations between patient outcomes and MPDS priority levels and specific determinant codes.
Outcomes, however, are not universal in application of a single CAQ system. Outcomes depend on data submitted to the Academy and analyzed according to specific study parameters and individual agencies taking advantage of the CAQ concept to establish local AED programs.