City of Austin

Austin’s medical director Mark Escott has heaped praise on the paramedics and firefighters who saved the life of former Pennsylvania Governor and United States Homeland Security Secretary Tom Ridge after he suffered a heart attack on a visit to the city just over a year ago.
 
Dr. Escott, Medical Director of the City of Austin-Travis County Emergency Medical System (ATCEMS), paid tribute to the City’s first responders today, January 10, 2019 at the annual meeting of the National Association of EMS Physicians, at Austin’s JW Marriott hotel.
 
He said the success of the urgent treatment provided by emergency medical and fire personnel at the same hotel in November 2017 had been made possible by the “well-coordinated systems of care between the EMS System and our hospital partners”.
 
He added: “Congratulations to our heroic first responders and our hospital partners who created remarkable luck for Secretary Ridge on November 16, 2017. You are all a credit to our system and our profession and the City of Austin is blessed to have you protecting our community.”
 
Secretary Ridge had suffered a heart attack and cardiac arrest in his hotel room. First responders from ATCEMS and the Austin Fire Department responded within three minutes and successfully resuscitated Secretary Ridge whose heart stopped three times. Secretary Ridge made a full recovery following hospitalization in Austin.
 
The crewmembers who responded to the emergency call were today recognized and thanked by Secretary Ridge in person, after he returned to Austin to give the event’s keynote speech.
 
They were ATCEMS Communications Clinical Specialist Dena Morgan, ATCEMS field personnel Clinical Specialists Brendan Cluskey and Kyle Schutt, Cpt. Marco Villasenor, and Austin Fire Department’s Cpt. David Heaton, and Firefighters Christopher Coggins and Anthony Segovia.
 
Speaking after the event, Dr. Escott said: “Successful resuscitation from sudden cardiac arrest is highly dependent upon a well-organized system of care with multiple critical links in the chain of survival. Governor Ridge’s case exemplifies the kind of outcome that is possible in the City of Austin when all of those links are maintained.”
 
In 2018, Austin-Travis County EMS received 122,900 calls and dealt with 800 resuscitations from cardiac arrest.
 
Additional background:

Successful resuscitation from sudden cardiac arrest is dependent on links in the chain of survival. The first, and perhaps most critical link, is the early recognition of the symptoms of a heart attack. Those symptoms include chest pain which may radiate to the neck, jaw or arm, difficulty breathing, or the individual becoming pale and sweaty.  For some, they may only have a sensation of lightheadedness or weakness. For others, the first symptom may be unconsciousness and loss of breathing and a pulse.
 
The second link, is rapid activation of emergency services through a call to 9-1-1.  Our EMS Department, Fire Departments, and some Police Departments, are rapidly dispatched while the EMS Communications personnel are still obtaining information from the caller.
 
The third link is early application of CPR as quickly as possible following the loss of pulse. While bystander CPR used to involve breathing via mouth-to-mouth resuscitation.  This step has been found not to be beneficial and was a significant barrier to performance of CPR.  If the individual calling 9-1-1 does not know CPR, our dispatch center personnel can provide CPR instructions over the phone. The Office of the Medical Director also coordinates a CPR program called Take 10 which trains members of the community as trainers in this new “hands-only CPR.”  In approximately 10 minutes, members of the public can learn to be life-savers. Without this critical step of bystander CPR, survival drops by 50%.
 
The next link in the chain of survival is early defibrillation.  This step used to be restricted to EMS and hospital personnel.  Now through Automated External Defibrillators (AEDs) this life saving intervention is available on every Fire Department apparatus, some Police Department vehicles, and even in public places such as airports and other public and private buildings.  The City of Austin has required all high rise buildings to have AEDs on every floor since 2003. The chance of survival drops by 7-10% for every minute that passes from the time someone’s heart stops until they receive defibrillation.  
 
In Governor Ridge’s case, because he contacted 9-1-1 before his cardiac arrest, he received immediate CPR and immediate defibrillation which dramatically improved his chance of survival.  When the combination of bystander CPR and rapid defibrillation is present, the chance of survival dramatically increases to over 54% compared to 7.5% if these critical interventions are not present. Another critical link is the rapid critical care services provided through our Austin-Travis County EMS Paramedics. 
 
The utilization of advanced diagnostic equipment, medications, and clinical interventions are vital components in survival. This is followed by transport to Cardiac Arrest Resuscitation Centers who are experts in management of cardiac arrest and acute myocardial infarctions, or heart attacks.