See Caregiver Viewpoint by Grams
I read Bobby Grams’ touching commentary about his experience as a bystander with a smile on my face—and hope. I have heard this story first hand from Bobby and his wife Karen and cannot help but think how every part of the chain of survival went right for Karen to have this great outcome. Bobby had to recognize a life-threatening situation, think quick on his feet, pick up that phone and call 911, and keep calm so he could follow dispatch’s instructions. Dispatch had to have the experience and know-how to effectively guide Bobby through cardiopulmonary resuscitation. First-responders had to get to the house quickly, bypass barking dogs, take over patient care, transport while continuing life-saving measures, and hand-off to the emergency room for definitive care. It all went right.
But, of course, so many others who experience out-of-hospital cardiac arrest (OHCA) are not as lucky. In our home state of Michigan, depending on where you arrest, the likelihood of survival to hospital discharge varies between 5% and 15%. We need to close this gap. Which community one arrests in should not dictate likelihood of survival. While we work on coming up with new therapies and devices to optimize the quality of cardiopulmonary resuscitation, we also need to focus on identifying what distinguishes high survival communities along the chain of survival. What is the “magic sauce” for survival in the field? What are the key system-level factors that increase the likelihood of OHCA survival in the prehospital setting?
Clinical Commentary on “My Experience as a Bystander” by Mahshid Abir