'Everyone should know CPR:' West Licking cardiac arrest efforts helping save lives

'Everyone should know CPR:' West Licking cardiac arrest efforts helping save lives
Karen Smith's heart stopped seven to eight times one day in September 2020.

The Etna area resident was working as a substitute teacher at Watkins Middle School when she collapsed between classes.

"All I remember is not feeling good (while) subbing at the school," she reflected during a recent interview with The Advocate. "I went to text my husband 911 and I texted 914. And that's all I remember."

She and her family credit the combination of students' quickness to seek help, teachers who started CPR, and the swift arrival of emergency personnel - which are all key parts of West Licking Joint Fire District's cardiac survivability plan - to her survival.

Increasing the odds

Seven years ago, a resident within West Licking JFD who suffered a sudden cardiac arrest outside a hospital had a 20% chance of surviving to discharge.

That number, while still double the national average, was not good enough for fire district personnel and board members.

According to WLJFD Battalion Chief Justin Weaver, their team pored through three years of data, identifying key factors to calls where those patients survived. He explained the national data characterizes a sudden cardiac arrest as someone who has a viable, shockable rhythm.

In 2021, the district had 42 calls regarding cardiac arrest. Of those, 21 people had a non-shockable rhythm. Ten were deemed survivable patients.

"One thing we did notice from all this data…is our average response time to a cardiac arrest was 5.5 minutes. The response time for those that survived to discharge was 4.5 minutes," Weaver said.

They looked at fire departments nationwide to see who had improved data, sending a member to Seattle, who had 50% survivability of a sudden cardiac arrest. They also looked at different treatment types.

The department listened to 911 audio from their cardiac arrest calls, looked at response times, acquired CPR mannequins which tell them how good of quality their CPR is, and initiated quarterly training.

"We saw we had a lot of deficiencies in the department where our response times were higher, so our goals were set at that point: We need to make sure we get to people in less than five minutes," WLJFD Assistant Chief Joe Krouse said. "In 2016, the fire board put the station on Taylor road to service that area because we saw there were slower response times to that area...In 2019, we built station five up in the Mink and Morse Road area because response times were too long for the district's liking."

Previously, Krouse said, it took the department an average of eight minutes to reach the Reynoldsburg and Jersey Township areas. Last month, their average response time to those areas was four minutes and 37 seconds.

Since making those adjustments, Krouse said they've seen their survivability for cardiac arrest reach as high as 75%. This year, the team was at 50% survivability.

"This year, we noticed there's a big difference and it's because we weren't getting the bystander CPR being done," he said. "There's a strong correlation to bystander CPR as part of the chain of survival - activation of 911, getting early CPR, getting defibrillation, getting there and continuing all the things we need to do, and getting good quality CPR."

A 'miracle'

"She didn't have a heartbeat for eight minutes."

One of Karen Smith's sons, Tyler Smith, tearfully recounted the minutes, hours, and days that followed his mom's heart attack.

When the next group of students came into the computer lab and discovered she'd collapsed, two students immediately sought help. Three teachers took turns performing CPR until EMS arrived minutes later.

Once at Mount Carmel East Hospital, Karen was stabilized. Her son said doctors didn't yet know she suffered a heart attack at that point.

“Her heart stopped like five more times that evening. The doctor came in and said that’s it so we unplugged everything," Tyler said. "They ordered a drug to come up and put her to sleep. And we said our goodbyes."

The family asked a hospital chaplain to pray. Tyler's brother asked his mom if she was ready. The family was stunned when she appeared to shake her head no. He then asked if she was ready to keep fighting, and she shook her head yes.

"She came back to. No memory loss. Her heart stopped seven, eight times. At the school, it was stopped an estimated seven, eight, nine minutes," Tyler said. Doctors didn't expect Karen to survive the night, but days later, she opened her eyes and then began to wake up. "Dozens of doctors have evaluated her and they just don't understand. They've never seen anything like this."

Karen said her only memory of the incident is the moments leading up to it and her recovery. She was hospitalized nearly a month and eventually, six stints were placed, along with a pacemaker including a built-in defibrillator.

The family attributes her survival to "a chain reaction of everybody doing what they should do" and quickly, from the students who reacted instead of freezing, the teachers who immediately began performing CPR, and having the new fire station so close to the school so EMS could begin their lifesaving efforts sooner.

Now a few years later, Tyler said: "The miracle of her surviving changed our lives."

'Everyone should know CPR'

Through West Licking JFD's efforts, residents now have over double the chance of surviving a sudden cardiac arrest than they did seven years ago.

But, the team believes those odds would improve with the community's help.

"We’re seeing that correlation of data when CPR is being done by the bystander and then we take over and continue the care, versus no CPR being done prior to our arrival and we take over the care," Krouse said. "We have a reduction in bystander CPR being done. It’s important if you have the ability to educate yourself, to know how to do CPR."

As part of their cardiac survivability plan, WLJFD sought to get as many people in the community trained in CPR as possible, so they trained teachers, high school students, police departments and the city's street department.

"The plan essentially initiated our direction. The fire board came 100% on board with it," Krouse said. "They realized the importance of it because they approved two additional stations and staffed them. That right there is positive effects for the community."

One thing their data hasn't been able to pinpoint is how many of those they've trained in CPR has gone on to perform CPR on someone else.

According to Krouse, from 2016 to 2021, 20 residents have walked out of the hospital from full cardiac arrest with little to no deficits - all thanks to their cardiac survivability plan.

Karen Smith is among them.

"I feel really blessed. I feel like I'm here for a purpose, to touch somebody's life," she said. "Everyone should know CPR. If (those teachers) didn't, I wouldn't be here."

The next step in WLJFD's cardiac survivability plan is for as many people as possible to learn CPR.

"We want to encourage people to take that step and learn CPR and benefit someone else," Krouse said. "And we will be there to help them take that step."