New cardiac protocols for Elgin EMS

The traditional approach for fire departments was to quickly transport patients in cardiac arrest to the hospital. However, research has shown that this method often led to poor outcomes because high-quality CPR is difficult to perform during movement or while in a moving ambulance.

Chris Kennedy, a firefighter/paramedic with the Elgin Fire Department (EFD), explained, “Studies found that patient outcomes were worse because it's nearly impossible to deliver effective CPR while moving a patient or when the ambulance is bouncing down the road. Additionally, hospitals have given paramedics more advanced skills so that what we can do in the field is now comparable to what ER staff can do.”

In recent years, the EFD has revamped its procedures for handling cardiac arrests. They’ve introduced new technologies, enhanced training through in-house sessions, and are working to raise public awareness about the importance of CPR knowledge.

According to Kennedy, the department responded to 108 cardiac arrest calls between 2012 and 2013, out of around 11,000 total emergency calls each year. He emphasized that high-quality CPR with minimal interruptions is the most critical factor in improving survival rates. When combined with shocks from a defibrillator or AED, this approach significantly increases the chances of return of spontaneous circulation (ROSC).

Pit Crew Style Response

To optimize care, the EFD now uses a pit crew-style approach during full cardiac arrests. This involves assigning specific roles to paramedics and EMTs to ensure continuous, high-quality CPR without delays. In many cases, a fire engine will also be dispatched to provide additional support, especially since newer units are equipped with advanced life support tools.

Cutting-Edge Monitoring Technology

All frontline ambulances and one ALS engine now use the Zoll X-series monitor, originally designed for helicopter transport. These devices allow crews to defibrillate, monitor capnography, and record vital signs. Paramedics can even capture 12-lead EKGs in the field and send them directly to the hospital via cell phone, allowing doctors to prepare before the patient arrives.

The department is also transitioning to an electronic patient care report (ePCR) system from Zoll, which will streamline data sharing and improve overall efficiency.

Hypothermia Protocol

Elgin EMS has also adopted a hypothermia protocol, based on research showing that cooling patients after ROSC can lead to better neurological outcomes. The theory is that lowering body temperature reduces cellular metabolic demand, helping protect brain cells from damage due to lack of oxygen.

“This is similar to how people who survive cold water submersion often recover better than those who drown in warm water,” Kennedy explained. If a patient regains a pulse, paramedics start administering cold IV fluids to lower the body temperature to around 93 degrees Fahrenheit.

While the protocol has shown promise, Kennedy noted that recent studies have not consistently proven its effectiveness, and more research is needed to determine its long-term benefits.

Overall, the Elgin Fire Department continues to evolve its approach to cardiac care, ensuring that patients receive the best possible treatment at every stage of the emergency response.

Thanks, Dan

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