People in Dane County experiencing cardiac arrest are nearly twice as likely to live compared to the national average if there is bystander intervention. In 2022, local cases in which the public intervened before the arrival of first responders had a 65% survival rate. The national rate under the same circumstances is 34%.
These latest statistics come from the Cardiac Arrest Registry to Enhance Survival (or CARES) program. Their database covers nearly half of the nation – 145 million people – and their ultimate goal is to increase bystander intervention through either chest compressions or AED use.
Cardiac arrests – when occurring outside of a hospital – most often strike in private residences. But loved ones and community members with a basic understanding of CPR and/or AEDs have the power to help. The medical consensus is that the earliest possible intervention – even from those without advanced training – vastly improves a patient’s chance of survival.
Dane County has been particularly successful in this area. Officials say the “exceptional survival rates” are largely thanks to bystander intervention. Eric Anderson, the county’s EMS Data Analyst, points to three main areas of success. Of these, two are due to efforts from the public: “So I think the first and the most attributable is the rate of bystander chest compressions before first responders arrive. We know the sooner that someone in cardiac arrest receives CPR the better chance they have of a good outcome…The next attributable benefit or factor is an increase in AED use, so Automated External Defibrillators. Persons who – if they go into cardiac arrest, if they have cardiac rhythms that would respond to an AED then they inherently have a better chance of survival but that rate goes way up and their chances go way up if that shock happens sooner. In the community we have just shy of 800 AEDs registered in our local AED registry, so we can now connect that to our 911 call center and they can recommend to people calling 911 whether or not there’s an AED within their location and where that is. We saw better rates of people placing the AED and the AED being available before 911 responders get on scene.”
Bystander intervention in Dane County saw a substantial increase in the last two years alone. According to the report, bystanders performed chest compressions in 40% of cardiac arrest calls in 2021. In 2022, this rose to 62% of calls. The newest report credits a number of elements that have likely precipitated this change. 911 dispatchers are consistently working to improve their on-call coaching, and CPR classes are more readily available to attend than ever. Anderson also credits Damar Hamlin’s medical emergency and subsequent resuscitation during the Bills versus Bengals game in January of this year with the increased public awareness.
According to Anderson, the third factor in Dane County’s success is the internal review of first responders, called ‘high performance CPR.’ “In EMS and in Fire [Departments], the resuscitation practice has really been focusing on the same principles we’ve been pushing to the public. The more time that we’re doing CPR, the better CPR that we’re doing and the faster that we’re acting on those rhythms that we can shock – that we can defibrillate – the better chance we’re getting our patients a good outcome. We have a pretty in depth and detailed review process, but the short version is that every single cardiac arrest that happens outside of a hospital with a 911 response in Dane County gets a detailed review of what happened and those crews get detailed and timely feedback. And we’ve seen – across all the metrics that we’ve set – steady and really promising improvement.”
But they say there’s always room to improve the rate of favorable outcomes. With AEDs cropping up in more and more locations, the county is encouraging bystanders to use them more in the future. During the time period the report covers, there were 118 incidents in which an AED was located nearby. However, they were implemented only 24 of those times prior to EMS arrival.
Dane County has several other programs in place that seek to continue this upward trend in cardiac arrest survival rates. Some focus specifically on the public’s education in CPR and the operation of AEDs. Dane County Emergency Management and most local EMS departments are a useful resource for those interested in receiving training.
Another promising effort is looking to streamline the response from qualified members of the community. Anderson says, “There’s an app that anyone can download. It’s called ‘PulsePoint’ … and what PulsePoint does is it alerts people to a cardiac arrest event within public locations within a quarter mile of their location … But anybody with a smartphone that has a PulsePoint app with the CPR alerts turned on could be notified.”
County Executive Joe Parisi says that public awareness is key. This week, he is encouraging members of the public to pay attention to the resources available in their everyday lives and to advocate for greater preparedness: “You know, if you work in an office – wherever you work – see if they have electronic defibrillators there and, if not, see if you can talk to the folks there about getting one put in the building to be available in case someone were to go into cardiac arrest. Because the more resources that are out there, the more defibrillators, the more people who know CPR, the quicker people can call 911, the more lives we’re gonna be able to save.”
