Part Two: ALF Ambulance Equipment Helps Increase Heart Attack Survival Rates

Editor's note: This is the second of two stories about Apple Valley, Lakeville, Farmington Ambulance services. looked at trends in ALF Ambulance response times, and cost to cities.

The ambulance that Apple Valley, Lakeville, Farmington Ambulance paramedic Brian Sturz works in is smaller and more cramped than the ambulances shown on television.

A six-foot-tall person can’t stand up straight inside. The truck is lined with overhead compartments filled with supplies. A medicine cabinet is behind the passenger seat. Between the two front seats is a computer that connects the paramedics to dispatch and provides GPS directions. A long stretcher takes up most of the rear bay, while padded benches run along the sides beneath overhead compartments.

The ambulance is not comfortable, but it’s efficient, which lets paramedics bring all the tools needed to respond to almost any emergency. The equipment has put the heart-attack survival rate for Allina patients at between 8.5 percent and 9.5 percent, according to Dr. Charles Lick, Allina Medical Transport’s medical director. The number might seem small, but it’s 70 percent above the national average.

The device paramedics use the most is the LifePak 12, said Sturz, who has been a paramedic for more than 17 years. The LifePak 12 is similar to the automated external defibrillators that are increasingly available in schools and other public places, but is more advanced.

Sturz said the device lets paramedics look at heart rhythms and acts as an external pacemaker and a defibrillator.

It is “able to see rhythms and determine if they need to be shocked,” Sturz said; it helps determine whether a patient’s chest pain is a heart attack, or whether it’s something else.

Cardiac calls happen often for ALF ambulance crews, but there are many calls for other reasons—for people with nausea and vomiting, for example.

Sturz said it’s always “better to be safe than sorry” when deciding whether to call an ambulance.

“We can come out and look at them,” he said. “There’s no charge for us to come and look.”

Since the recession began, Sturz says he’s seen more patients who are reluctant to actually be transported to the hospital.

“We believe the financial concerns of our patients are impacting the number of transports,” said Allina Medical Transport operations manager Jeff Czyson.

An Allina report to the Lakeville and Apple Valley city councils shows ambulance calls and transports were increasing at about the same rate from 2005 to 2008, according to the report. Then, the number of ambulance transports dipped as the number of calls continued to steadily climb.

Czyson also said he has heard from nurses that more patients arrive at the Emergency Room by personal transportation.

But in cases where a patient needs CPR, there is really no choice but to travel by ambulance, which is when another piece of ambulance equipment—the LUCAS chest compression system—comes into play.

The LUCAS is an “unbelievable piece of equipment,” Sturz said.

A back brace fits under a patient and an arc fits over the patient; a bellows-like part hangs from the top. The system is run on compressed air, connected to a tank that will last 30 to 40 minutes. The air forces the bellows down onto the patient’s chest, performing the compression part of CPR with “perfect rhythm and level,” said Sturz. It works longer and better than a human.

The idea for the LUCAS was conceived in 1991 in Norway. It was approved for use in Europe in 2002 and by the U.S. Food and Drug Administration in 2007. ALF starting carrying the equipment in 2009 when its contract with Allina began, Czyson said.

Erik Denny, communications program manager for Physio-Control, which makes the LUCAS, said interest in the device from EMS services and hospitals is growing.