Saving lives: Johnson County program sends alerts to trained laypeople to respond to cardiac arrest cases.

When the Buffalo Bills’ Damar Hamlin collapsed on the field of Paycor Stadium this month, a team trainer quickly began chest compressions (Cardiopulmonary Resuscitation — CPR), which restarted blood flow to his brain, followed by electrical shocks with an Automated External Defibrillator (AED), which shocked his heart back into rhythm. When Maryland fan Stan Goldstein collapsed in the Carver-Hawkeye Arena during a basketball game here at the University of Iowa a year ago, he was resuscitated by UIHC Emergency Medical Department staff who are present at major university competitions.

But most of us who suffer a cardiac arrest will not be accompanied by a well-equipped trainer or a medical support team. A heart attack is caused by a blockage in an artery that leads to the heart. It is very serious but its impact is rarely instant; there is time to get to an emergency room. A cardiac arrest, by contrast, means the heart has stopped. If oxygen does not get to the brain in less than 10 minutes, survival is unlikely.

This week, Johnson County was recognized as a HeartSafe Community by the Citizen CPR Foundation in recognition of impressive gains in training lay people in CPR, and substantially increasing the number of AEDs throughout the county. [Note that the State of Iowa now requires all high school graduates to be instructed in CPR).

Three years ago, the Iowa City (Noon) Rotary Club, in collaboration with the Johnson County Ambulance Service and the Johnson County Board of Supervisors embarked on the Rotary-Kerber HeartSafe Campaign, named for the late Dr. Richard Kerber of the University Hospitals and Clinics, who was a pioneer in the science and practice of cardiac resuscitation. The Campaign has provided deeply discounted AEDs to more than 50 nonprofits (including houses of worship) and businesses at a sliding scale, contingent on their training their staffs in CPR (CPR training was suspended because of the pandemic, but has now resumed); placing 20 AEDs in weatherproof outdoor kiosks available 24/7, with 14 more to be placed in 2023; providing weatherproof cabinets for AEDs placed by the school district in the high school athletic fields; and assisting the Johnson County Board of Supervisors and the Johnson County Ambulance Service in acquiring the PulsePoint app system. When a 911 call about a cardiac arrest is placed, PulsePoint will alert a CPR trained person within 1,300 feet, whose phone will signal where the victim is and where the closest accessible AED is located. As many as 2,588 people in Johnson County have now downloaded and activated the PulsePoint app. There remain areas which are not yet covered by potential responders.

It is well established that the sooner CPR is begun, the better the outcome. If a PulsePoint alerted person begins CPR even a few minutes before the first responders (police or firefighters who are summoned by the 911 call) arrive, the chances of survival increase substantially. And the more people are trained — in their houses of worship, their businesses, their schools — the more likely it is that a lay rescuer will be near the victim. In 2022, the national average of success for first responders is now barely 7 percent. In Johnson County it was 10.4 percent. Early CPR/AED triples the chance of survival; in some areas of the country it is now as high as 40 percent.

What you can do:

1. From now on, notice AEDs wherever you go. When a lay rescuer begins CPR they will yell “Someone get an AED!” You can be the person who knows where the closest one is.

2. Get trained in CPR. If you were trained more than 2 years ago, get retrained now. You need to refresh your muscle memory. And guidelines change: mouth-to-mouth breathing is no longer recommended when a cardiac arrest is witnessed in adults (it still is a recommended for young kids).

3. Add the PulsePoint app to your smartphone and enable “critical alerts.”

Let us make all of Johnson County as safe as the Paycor Stadium.

Linda K Kerber, Rotarian, Ambulance Service; Fiona Johnson, Director, Johnson County; Dianne Atkins, MD Rotarian, and James Merchant, MD Rotarian.