By Audrey Fraizer
Going about daily business in a golf cart is just one plus of spending your golden years in The Villages retirement community in central Florida.
And the carts are also a particularly efficient mode of travel when seconds used effectively result in years added to the life of a person experiencing cardiac arrest.
“Five people on three golf carts, with one AED [automated external defibrillator], arrived in less than a minute,” said Lew Simon, a retired financial consultant and resident in one of the many gated communities making up “Florida’s Friendliest Hometown.”
“She was 91, and went into cardiac arrest related to heat stroke while she was gardening,” he continued. “She was out of the hospital the next day.”
The neighbors were volunteers in the Neighbors Saving Neighbors program that Simon introduced in 2003 to his gated community (53 homes) within The Villages retirement mecca.
Neighbors Saving Neighbors places AEDs on resident properties throughout The Villages and trains residents how to use the devices, along with how to perform hands-only (compressions) CPR.
The number trained is up in the thousands, although it would be impossible to give an exact figure because of demographics. The Villages is a huge retirement community (55 and older) made up of smaller neighborhoods, called Villages, totaling a population comparable to Manhattan (N.Y.).
Capt. Gail Lazenby, The Villages District Public Safety EMS training and quality assurance officer, who oversees The Villages program, said a better indicator is the number of neighborhoods involved and the number of households registered in each of these neighborhoods.
According to Lazenby’s records, as of June 1, 2014, there were 12,118 homes in 140 neighborhoods registered. Two or more AEDs are strategically placed in each neighborhood—usually on the outside of residential homes—and additional AEDs are available at community gathering centers, such recreation centers, churches, and softball complexes.
Prior to any AED installation, neighborhoods must agree to a one-time start- up fee to purchase the AEDs and accessory items—waterproof case, cabinet, and the first set of replacement batteries. Exact figures vary according to the number in each neighborhood signing up to participate and many communities shave future expenses—batteries and extending the notification contract—through fundraisers, such as raffles.
But the “dues,” which for the start up generally run between $100 and $175 per contributing household, don’t determine who is eligible for the lifesaving measures in cases of cardiac arrest.
“We’re certainly not going to ignore someone in trouble,” said Simon, who lives in The Village of Sunbury. “No matter who pays, everyone in a designated community is covered.”
Simon believes the potential and actual results of the initial investment far outweigh the cost; those initially hesitating to chip in usually climb on board once witnessing or hearing a success story.
“What this program can do is mind-boggling,” Simon said. “You’d be amazed at the number of people we’ve saved.”
“Saves” are defined by the ability to walk out of the hospital, Lazenby said. And the statistics, according to a district public safety report, show The Villages occupies an enviable position.
Overall, The Villages’ survival rate for cardiac arrest went from 16.75 percent in 2004–2005 to more than 40 percent in just four years.
In fiscal year 2012–2013, the district fire department handled 68 cardiac arrests and saved 28 patients. The 41.2 percent survival rate dwarfs the national estimated average of 9.5 percent in reported cases in 2013, as documented by the American Heart Association (AHA).
By all indications, things are only getting better, according to a story published in the March 30, 2014, edition of The Villages Daily Sun.
From March 1, 2013, through Oct. 30, 2014, the department worked 37 cardiac arrests and saved 17 patients—a 46 percent survival rate.
Lazenby likes to say he lives in a “heart-friendly community.”
“We are without a doubt more successful than the national average,” he said. “And the crazy part is that there’s nothing magic about this. It just takes the right people to get it started and keep it going.”
How it works
When the call comes into the communication center, and the symptoms correspond to a suspected cardiac arrest, the EMD assigns the case an ECHO Determinant Code (or in a few cases, a DELTA Determinant Code), dispatches ambulance and fire, and assigns the AED unit in the computer-aided dispatch (CAD) terminal.
The action of entering the AED unit in the CAD activates a Web-based emergency notification system—ReadyAlert—that transmits the alert to each address in a neighborhood coded to receive the notification via cellphone, PDA, and all e-mail and text accounts. The recipients have volunteered their information for this specific use.
Volunteers arrive on foot, by golf cart, or through whatever means available to assist, with the tasks performed specific to the order of their arrival.
For example, the first volunteer on the scene would begin hands-only CPR and the second person might stand at the curb waving a flashlight to direct the ambulance to the proper location. The third volunteer might be carrying the AED and hand it over to a fourth volunteer who will use the device to determine if and when a shock should be delivered to restore the heart’s normal rhythm.
Simon had his first save four years into the program. On Nov. 14, 2008, his neighbor, Dr. David Rowland, collapsed in the kitchen, slamming his head against the dishwasher and falling unconscious to the floor. Rowland’s wife, Donna, called 9-1-1.
After dispatching paramedics, the dispatcher at the Lake-Sumter Emergency Medical Services communication center sent out alerts to Rowland’s neighbors’ pagers. The neighbors rushed to the Rowland home and unable to find a pulse, one of the neighbors started compressions-only CPR. Simon’s wife, Sherrill, arrived with the AED. While one neighbor continued to pump Rowland’s chest, another set up the AED and placed the paddles. The two jolts delivered by the neighbors were followed by two more from EMS responders arriving several minutes after the call was placed.
Simon was in Sarasota, Fla., teaching CPR at the time, but he had trained everyone in the group who rushed to the Rowland home, using the AHA-approved method of hands-only CPR.
“I received the page and called my son, who was living at home,” Simon said. “He told me mom was already on her way with the AED.”
Rowland was wheeled into the ambulance and transported to The Villages Regional Hospital. He survived, despite the 10 minutes without a heartbeat, and underwent a quadruple bypass three days later.
“He’s still playing golf three times a week at age 76,” Simon said. “You’re right, I am proud of this program.”
The dispatch component is integral, and it’s a process that does not interfere with either providing Pre-Arrival Instructions or sending ambulance response.
“There’s no disruption in service,” said EMD Cynde Earls, Lake EMS CAD/GIS administrator. “The volunteers are notified, and they respond while the dispatcher continues the protocol and the ambulance is on its way.”
Lake EMS was the first communication center to go with the program and Earls built a data set to correspond with the communities. Through the years, she has worked closely with Simon and Lazenby to operate the program.
“We’re the bridge,” explained Earls, who has been with Lake-Sumter and Lake EMS for 12 years (Rural/Metro Ambulance now provides 9-1-1 emergency medical services in Sumter County). “We had to be involved for the program to be effective.”
Simon was able to get his foot in the door after approaching Mike Tucker, fire chief of The Villages Public Safety Department, and convincing him of the win-win in training residents to provide CPR and AED assistance while waiting for EMS crews to arrive. The two of them arranged a meeting with Lake EMS Communication Center Chief Kimberly Stephens. Simon wasn’t optimistic.
“I thought she would give the bureaucratic excuse like, ‘If we do it for one, we have to do it for the others’ or ‘We don’t have the technical capabilities,’” Simon said. “I was wrong. She was all for it. Kimberly agreed that saving even one life would make the program worthwhile.”
Stephens said Simon almost instantly sold her on the concept.
“Everything he was saying made sense,” she said. “While he was talking, the wheels were spinning. Before he left I had some ideas of how this could work.”
Stephens guided the reins into the operative mode, with Earls coming on board when she was hired. Earls ran the dispatch side of the program from 2007 until last year, when the program was passed to Sumter County EMS for reasons related to consolidation.
Despite the change, Earls and Stephens remain strong advocates and talk up the program’s benefits in front of any audience that will listen. Both were among six speakers at the Neighbors Saving Neighbors session offered at NAVIGATOR 2014.
“I firmly believe in this,” Earls said. “It’s very satisfying to know that we have yet another resource arriving at the scene. We’re able to get people there as fast as humanly possible.”
Stephens admits that she misses the direct connection.
“But at the end of the day, it’s about the person benefiting from Neighbors Saving Neighbors, no matter who’s pushing the button,” she said.
The zeal is making contact in other centers.
The Villages program is 11 years in the making—and still growing—and two other counties in Florida have adopted the effort, although their programs are less concentrated, which can be attributed at least in part to the unique environment offered in The Villages.
Simon travels the country giving talks and rendering suggestions for getting at the heart of acceptance and implementation.
“You have to motivate the fire chiefs,” he said. “If the fire chief says he wants it done, and assigns someone to the project, it will get done.”
Lazenby believes the program will continue to spread, although he admits the dedication demanded can appear overwhelming to public service officials and community residents.
“They might like the idea, but it does take a lot of time to get it going and to monitor,” said Lazenby, who regularly conducts mannequin drops to test the time sequences—call to dispatch, alert to Villagers on scene and commencing CPR, and when the ambulance arrives on scene. “Not everyone has the time to make that sort of commitment.”
Lazenby’s commitment is telling in his retirement, effective June 6, 2014, which doesn’t really mean an end to his 46 years in EMS and firefighting, with the last 11 years spent with The Villages Public Safety Department.
In fact, it’s the second time that Lazenby has retired since 2003, which is the year he left the Grand Island Fire Department in New York to invest his golden years at The Villages. He heard about the opening in training and, as the saying goes, that’s all she wrote.
His first date to retire—Feb. 28, 2014—was met with a request to stay on and that’s what he did, putting in long hours to keep his training programs on track. He didn’t take the retirement. His second retirement met similar resistance, and this time he has agreed to work eight to 10 hours per week exclusively devoted to Neighbors Saving Neighbors. Someday, he might even actually retire.
“This program is definitely my baby and without a doubt, I wasn’t going to walk away until the right person is ready to take it over,” Lazenby said. “It wasn’t my idea but I am the one to run with it at The Villages for now.”
Simon said the program is his opportunity to give back.
“It’s a great feeling every time I hear of a life saved because of the program,” he said.
Note: For more information about using Neighbors Saving Neighbors in your community, contact Simon at AVLIVE@aol.com.