You might stand a better chance of surviving a heart attack just by living in Marblehead.
One to two saves, that is what Marblehead Fire Department used to make in a year when it came to cardiac arrest patients, but a new tool has changed all that.
The Lucas device, which essentially replaces a person when it comes to doing chest compressions, has boosted MFD’s save rate to 9 in the last year.
“Actually it was 10, but we had to take it off [the patient],” said Firefighter/Paramedic Matt Patterson. “So we’re not counting that one.”
“It’s a huge deal for us,” said Fire Chief Jason Gilliland. “It’s certainly improved morale.”
How it works
A cardiac arrest scene is normally organized chaos, Gilliland said. The driver is setting up the defibrillator, which Gilliland said is still the number one device when it comes to saving lives.
Interesting fact: Marblehead has over 250 defibrillators scattered all over town.
“We have one defibrillator for every 75 people in town,” he said. “They’re in Tedesco, the municipal buildings, the Electric Light trucks, schools, restaurants. They’re all over.”
The portable defibrillators can talk anyone through what to do in a crisis, Patterson said. In the meantime, a second firefighter is starting CPR, while another gets the Lucas device ready. If the defibrillator can’t shock the heart into a rhythm, the Lucas device is put into action.
A narrow, slightly curved backboard is slid under the patient and the device is placed over the patient’s chest, like an arch, and attached to the backboard. A fist-sized plunger is then triggered to start compressions, which at first are delivered continuously. Gilliland said he believes the success of the device is in part owed to the continuity it delivers.
Patterson said one of the problems with humans doing compressions is often they get fatigued quickly and the rhythm drops dramatically. Continuity in the amount of pressure applied and where can also suffer. The Lucas device provides steady action, which also frees EMTs up to tend to other medical issues particularly in the ambulance, Patterson noted.
Patterson said when their patients roll into the ER now, they have a pulse and that wasn’t always the case in the past.
“People normally recover more in the ER,” he said.
“It’s been a great success,” Gilliland said. “The numbers are so outrageous for us.”
In fact, the department’s numbers are roughly 2% – 2.5% better than the state average when it comes to cardiac saves, he said.
How it came to be
Patterson said they acquired two of the CPR devices about a year and a half ago when COVID-19 was settling in to stay, one for each engine.
Gilliland said the purchases were largely driven out of safety for the firefighters. The Lucas device allows them to treat the patients without getting, quite literally, on top of them and in their faces.
“They go for $17,000 apiece,” he added. “We were lucky enough to get them with COVID funding.”
Patterson said without that funding, the department never could have afforded the devices, which have more than paid for themselves in lives saved.
The only big concern is hanging onto them, Gilliland joked. Because Engines 1 and 2 are Class 5 non-transporting ambulances, a patient has to be transported by an ambulance company, sometimes with the device still attached.
Gilliland said firefighters usually follow to get the devices back. He also said the doctors and nurses that work in the emergency rooms have been amazed at the results.
Another possible tool
With two Lucas devices in service now, Gilliland said he has his eye on another tool that basically measures how much carbon dioxide a person is exhaling.
“That tells us how well we’re doing,” he said. “It tells us how well the Lucas device is doing.”
Patterson would simply like everyone to learn CPR. He said there are communities, particularly on the West Coast, which he calls the Mecca of emergency services, where CPR is taught in high school and is a graduation requirement.
“People are hesitant to do it and the thing is using hand compressions only, without breaths, has proven to be just as good,” he said.
But maybe not quite as good as the Lucas device.