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Kanawha introduces new cardiac arrest protocol for medics

By Candace Nelson

CHARLESTON, W.Va. - Rather than being transported immediately to a hospital, cardiac arrest patients in Kanawha County now will receive CPR for at least 20 minutes on the scene.

A new countywide protocol requires medics who respond to such patients to perform CPR that long before transporting them to the nearest hospital, said Dr. John Turley, medical director of the Kanawha County Emergency Ambulance Authority.

The protocol has been in the planning stages for about six months, Turley said. It has been phased in over the last few weeks and will go into full effect this week.

The authority held a press conference Tuesday to inform the public.

"We've read all these studies showing the effectiveness," Turley said.

"There have been nationwide studies for 10 years that a patient has a better chance of survival if CPR is performed on site with uninterrupted chest compressions. 

"Traditionally, the practice has been to load the cardiac arrest patient into the ambulance and get to the closest hospital as soon as we can.

"It's impossible to perform effective CPR while moving; the patient needs to be stable and with more than one provider. The average person wears out after two minutes."

Medics were losing valuable time on transport that could have been used to perform effective CPR, Turley said.

The new protocol, called "20 minutes for life," is designed to improve the chances for the return of spontaneous circulation in the patient and for neurological survivability.

"We usually have between 130 and 140 cardiac arrests per year in Kanawha County. Survival rates have never been good," Turley said.

"We want them to not just be alive, but at the end of CPR, to be mentally intact. That's only about 5 percent of them."

With the use of automatic defibrillators and CPR performed on the scene, survival rates have increased to about 12 percent. The national goal is 15 percent.

"We may be able to make marginal increases (with the new procedure)," Turley said.

"One of the limiting factors is that most people who have cardiac arrest are quite elderly or have multiple medical problems in addition to heart problems that make it difficult to resuscitate them."

Special circumstances such as cardiac arrest related to automobile accidents, electrocution or pediatrics still may require a direct trip to the hospital.

Authority officials unveiled a ":20 for Life" logo, which represents the 20 minutes of uninterrupted chest compressions recommended for the best chance for survival.

An 8-inch vinyl decal bearing the logo will be placed on the back of Kanawha County ambulances to spread the message to the community.

Carolyn Karr Charnock, the authority's public relations director, designed the logo.

"I just batted around some ideas, and the logo showing 20 minutes has ticked stuck," Charnock said. "We want the message to stay out there -- not just announce that we're changing -- we want the community to be aware that this is a program that will save lives."

Mike Jarrett, authority safety officer, encourages people to enroll in public CPR classes.

"We want our community to know," he said. "We want CPR classes to be as common as walking down the street.

"We have public CPR classes that are available now every Friday. If we get on scene, and you've been doing CPR for five or 10 minutes, you've become the first first responder. Citizen responder is the term that came out of Sandy Hook. You're helping us."

The Kanawha County Commission is sending 23 members of its staff, including Commission President Kent Carper, to be trained on the CPR protocol. Carper also serves on the authority board.

"I know we are supportive of this initiative and feel like it will save lives," said Jennifer Sayre, Kanawha County manager.

For more information on CPR classes, call the authority at 304-345-2312.

Contact writer Candace Nelson at or 304-348-5148. Follow her at


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