PUTTING ISSUES INTO PERSPECTIVE
SANTA’S GIFT OF LIFE
The importance of a ‘resuscitation recipe’
By A.J. Heightman, MPA, EMT-P
Ho, ho, ho! After completing a prac- tice run to prepare for my annual trek across the world on Christmas Eve—
something I do to ensure I don’t miss any homes
and to get the reindeer in shape for the long
journey—I sat down to debrief with my reindeer and elves.
The trial run turned out to be a good opportunity to test out the new oscillating red LED
nose that Rudolph had implanted in the off-season, and the micro-drones we’ll be deploying to speed up the delivery of gifts this year.
At the postflight meeting, I asked my hard-
working reindeer to load up lots of presents that
I want to give EMS systems to use as soon as
possible; things like: citizen alert software, CPR
feedback devices, end-tidal CO2 monitors, air-
way assistance devices, mechanical CPR devices
and some compact extracorporeal membrane
oxygenation (ECMO) devices for EDs, aero-
medical services and for ward-thinking hospital/
prehospital response systems.
I also asked the elves to mark multiple
addresses to ensure the delivery of extra cookies and gifts to EMS agencies and personnel
who have truly excelled in their resuscitation
research, clinical work and operational changes.
They all dutifully agreed to carry out their
assignments, but several said they had questions
they’d like me to address.
WHY SO FEW?
The main question the elves had was why there
were so few places on my list who had earned
the extra cookies and presents for their resuscitation efforts.
I told them that, sadly, most EMS and fire
agencies are still using traditional or obsolete
methods for patient resuscitation and, as on old,
chubby guy at risk for cardiac arrest, I want to
reward those who have the best chance of resuscitating me if I collapse in their service area.
A few of the reindeer questioned why I was
going to be giving out extra resuscitation tools
at all, since the reindeer chatter in the stable was
that it’s impossible to achieve a return of spontaneous circulation (ROSC) rate greater than 10%.
“Ho Ho Ho, NO NO NO!” was my immediate reply. I added, “You dedicated, beautiful hoofed helpers are misinformed and have
fallen into the false belief that many have fallen
into: that 10–20% ROSC is the best we can do.
In fact, there are currently services achieving
ROSC 40–70% of the time.”
Donner giggled, Prancer pranced, Dasher
snorted and Vixen blurted out, “That’s a bunch
of reindeer poop, Santa! No one’s achieving
My face turned as red as my red velvet suit. I
opened my iPad and began to show them EMS
systems that were achieving not just 40–70%
ROSC, but experiencing patients walking out
of the hospital neurologically intact after
several hours on mechanical compression devices
and several days on ECMO.
They still didn’t believe me, so I sent them
off to the workshop while I pondered how to
get my resuscitation message across to them.
I felt bad for upsetting them, but I was frustrated because they held archaic impressions
of what was acceptable. I could convince them
to modernize the time-consuming practice of
whittling toys for children by using computers
and 3-D printers, but I couldn’t convince them
that old resuscitation practices were no longer
cutting the mustard!
The Rialto Fire Department developed seven cardiac survivability tools to increase neurologically intact survival from sudden cardiac arrest. Photo Rick McClure