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December
16

Controguerra Life. A defibrillator on our territory

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"Controguerra Life" is a project of the town of Controguerra (TE) to turn on its territory, a station equipped with a semi-automatic defibrillator (AED) with staff ready to intervene in a timely approach cardiorespiratory arrest.

The project was approached in January this year, finally sees a major step yesterday with the award by the City Council, the necessary funds for the project.

Therefore, it is virtually certain the purchase of AEDs by the end of this year and the training of civilian personnel to the use of AEDs in the early months of 2011, according to the time and manner of the operations center 118 of Teramo.

The project is innovative because, in the rare case the national scene, is based on a group of rescuers, said first responders, rescue workers who are not trained professionals but ordinary citizens to use the AED and other emergency tools.

A possible functional flowchart of the system is a system which, in response to a cardiac event in the municipal area, a national alert the operations center 118 (CO118) zone, which activates the classical measures to be sent, the target of ambulances. The operations center performs a call to the unique number of the project or, alternatively, public communication is made on an additional number to call in case of a cardiac event.

The switchboard of the project will make some calls (8 at a time) on the mobile numbers of first responders, who receive a recorded voice informing them of the call CO118. The first to take the call and be available is put into communication with the CO118 or place of the

The rescuer goes to the safe which is close to the town hall and picks AED and medical bag and went on target for first aid while awaiting the rescue of the basic and advanced.

The system is based on the following

  • A combination safe located outside the town hall of the town of Controguerra equipped with AED and medical bag with O2, Ambu bag, reservoir, guedel, etc..
  • An ISDN PBX / VoIP for receiving emergency signals and call of the first responders
  • 16 first responders

And it is these 16 people including the commander of the municipal police, the mayor, civil servants, doctors, pharmacists, businessmen and ordinary people who have given their willingness to follow the training course and take action if necessary by the community that I extend my sincere thanks to the first because it is incumbent upon them the responsibility to be present and ready when needed.

Obviously a solid contribution made to applaud and support from the entire municipal administration, directors of the majority and the minority who believed in this project and considered valid.

And a special thanks to the Green Cross of Villa Rosa Martinsicuro who has followed and supported the implementation of this project and which will bear the burden of training of first responders who rushed in and with the support of doctors and the operations center 118 because of Teramo, the project will be accredited to the Abruzzo region of Teramo and CO118 in accordance with the resolution of the Regional No 1051, 28.11.2003 under the draft early defibrillation in the region .

If you are interested, specifically, the project, the one below, read on, is the document that presents and explains in detail the genesis and characteristics ..

General info on the arrest cardiopulmonary

Sudden cardiac arrest is a major cause of death in the world. A 2004 research showed that only 60,000 in Italy (1) people are affected each year, or about one person in the nineteenth century, for a total number of deaths much higher than AIDS deaths (~ 200 per year) or road accidents (~ 7500).

The lack of obvious symptoms of heart failure is a phenomenon in most cases unpredictable. Not being able to act preventively, the only possible form of assistance is ex post, through emergency action must take place in the moments immediately following the event.


The evolution of cardiac arrest to the biological death usually goes about in eighty percent (2) of the cases, for a pulseless ventricular tachycardia (VT) and ventricular fibrillation (VF), which are generally the pace of onset of cardiac arrest and then to decay within a few minutes, a low-voltage PV, and ultimately to asystole within a few more minutes biological death occurs.

The only effective therapy for circulatory arrest from VF is represented by defibrillation combined with a proper cardiopulmonary resuscitation (3) .

Survival times

However, recent statistics say that less than 5 percent of people suffering cardiac arrest survives, and this as the emergency services do not arrive on time.

In fact, statistically, for every minute that passes since the onset of cardiac arrest decreases by 10% the chance of survival of an individual, and then after 10 minutes the possibility of life is reduced to very few cases. This means that for every minute lost ten per cent that could be saved, in fact die.

If nothing can be done to those who unfortunately cardiac events occur in the absence of witnesses and the fact remains that about 70% of cardiac arrests occurs in the presence of witnesses (4) .

But even so, just follow the standard timing related to a cardiovascular attack in the presence of witnesses, to realize that time is really precious. In fact, usually the first minute passes so that people who are close to those who feel bad, they realize what is happening and be alerted the 118 or spend another minute to call management and for enabling ' crew rescue, and this is added last, the time the ambulance, even in emergency, to reach the place. A last minute to finally spend the history of the patient and the application of DAE.

Whereas, the town of Controguerra, AEDs are closer to the Civil Hospital Val Vibrata Sant'Omero, the Green Cross of Villa Rosa and the garrison of medicalized Tortoreto

and, at an average "emergency" of 80 km / h, we obtain the following estimates of our arrival on the territory of emergency vehicles from these health centers with the following timing.

Thus, as can be seen from the chronogram below, before the event rate, the first shock of the DAE will be made at least after about 10 minutes and 30 seconds making really ridiculous the possibility of recovery of a patient in cardiac arrest.

It is therefore of fundamental importance for the possibility to reduce the time by which the life-saving instrument par excellence, the AED becomes available.

The aim of the project "Controguerra Life"

The project "Controguerra Life" has the expressed goal of making available to the municipality at least A semi-automatic defibrillator and staff trained on site ready to intervene at the report, as quickly as possible.

The project, of course, not an alternative to EMERGENCY 118, but began as immediate support to the national emergency by providing equipment and personnel to provide on-site in order to reduce the operating time of the patient and ensure that, at ' the 118 ambulance, the patient has already been treated with one or more defibrillation and kept alive by an effective cardiovascular resuscitation so as to maximize the chance of survival due to timely action of the rescue.

The usual chain of survival

should be handled according to the following

This allows a more effective and timely action on the patient as evidenced by the graph below

E 'patently obvious fact that there is, in this case, early defibrillation in the treatment of the patient over four minutes which is equivalent in human terms, to save more than forty people in a hundred.

In addition there is also the consideration that the intervention treatment of the ambulance with doctor on board the 118 is enhanced by the presence of specialized staff at the venue that can quickly, summarize the conditions the team event In addition to the 118 is already running, so the AED can now move on to advanced treatment with drugs by further increasing the survivability of the patient.

This theoretical analysis is even more evident when compared, for example, the response time of a recent case happened on our territory which, although not a cardiac event, has engaged the entire chain of events described above.

In this case was that after a couple of minutes there was a spot of general practitioners operating in our country and after about four minutes, another qualified rescuer was present at the event.

With regard to the activation of the rescue instead of the 118's on to note that the Green Cross ambulance arrived at Villa Rosa is about a minute before that of the hospital Sant'Omero.

So, if already in the theoretical case, the fork between the local and the intervention of the 118 was already extensive in the real case considered this fork has become more than ten minutes between the arrival of any first aid to the local arrival the first ambulance.

Implementation modalities of the project

The project has the goal to significantly increase survival in the municipality of Controguerra of patients suffering from cardiac arrest by immediate treatment with early defibrillation (within 5 minutes), by "first responders" trained and properly trained in resuscitation Cardio-Pulmonary and use of automated external defibrillators (AEDs).

The active elements of the project are:

  • A kiosk containing an emergency defibrillator semi-automatic
  • A system for collecting telephone "number one" with advanced Asterisk PBX for call forwarding to mobile numbers of first responders to find the first available
  • The "first responders"

Once the defibrillator purchased by the city administration is expected, in agreement with the operations center 118 of Abruzzo, a course the full cost of the service with staff qualified in the 118 procedures for resuscitation and defibrillation to patients in custody for cardiovascular n. 16 citizens of the town of Controguerra who wish to participate actively in this latter project, becoming an active and executive as "first responders".

Those parties who have no role in health care, also known as "secular", identified in the community, to work, attendance at places of aggregation town layout and feeling of participation, will be selected to activate the territorial spread of early defibrillation.

It 'worth noting, however that, even now, residents in the municipality of Controguerra, are subject fitted with the use of the AED certification, and can thus immediately become a full member in the chain of survival from the project already' purchase of the AED.

One could envisage a flowchart of the event only on the part managed by the project Controguerra Life as follows.

Obviously as a primary event remains outside of this flow parallel to the call alert national emergency number 118.

It may be possible to verify the possibility that the central 118 directly, once identified an event in the town of Controguerra, to call the number for the local awareness of the rescuer.

Laws regarding the use of AEDs

Art 593 cpp - wrongful death

Anyone who, finding lost or abandoned a child under the age of ten, or another person unable to fend for herself, for sickness of mind and body, old age or other cause, fails to give immediate notice to the Authority, is punished with imprisonment up to three months or a fine of up to six hundred thousand pounds. The same punishment who, finding a human body that is or seems lifeless, or an injured or otherwise in distress, fails to give assistance as needed or to give immediate notice to the Authority. If such conduct by the offender resulting from personal injuries, the penalty is increased, if it results in death, the penalty is doubled.

Article 2236 Civil Code - Responsibilities of the person undertaking the work

If the provision requires the solution of technical problems of special difficulty, the person undertaking the work is not liable for damages, except in cases of intent or gross negligence.

Article 2050 Civil Code - Responsibility for the operation of hazardous activities

Anyone who causes damage to another in performing a dangerous activity, by its nature or the nature of the means used, and shall provide compensation, if not proof of having taken all reasonable steps to prevent the damage.

Law of 3 April 2001, no 120 "Use of semiautomatic defibrillators in-hospital environment" published in the Official Gazette No. 88, April 14, 2001 March 15, 2004 and Law No 69

Article 1. E 'possible use of the AED in the intra-hospital and also to non-medical health professionals and non-medical personnel who have received specific training in the activities of cardio-pulmonary resuscitation.

LAW December 23, 2009, No 191 Provisions for the formation of the annual budget and multi-state (Finance Act 2010).

Article 46. E 'authorized the expenditure of € 4 million for the year 2010 and EUR 2 million for each of the years 2011 and 2012 aimed at the dissemination of semiautomatic and automatic external defibrillators. By decree of the Minister of Health, issued jointly with the Minister of Economy and Finance, after reaching agreement in the Joint Conference of Article 8 of Legislative Decree 28 August 1997, No 281, as amended, are established criteria and procedures to provide defibrillators in places, structures and vehicles, within the spending limit established by this paragraph.

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