It is estimated that 1,000 people die every week from traumatic brain injuries in the United States. The care you receive before arriving at the hospital often is the difference between life and death.
If you suffer a severe brain injury in Arizona, you likely will receive the best EMS treatment available in the country, thanks to the Excellence in Prehospital Injury Care, or EPIC, project.
The National Institutes of Health chose Arizona as the only state to evaluate the national standards for prehospital emergency care of traumatic brain injury, or TBI. In the most comprehensive endeavor of its kind, almost 100 fire departments and ground/air ambulance companies have been trained in the national standards, covering more than 80 percent of the population. Those agencies send treatment information to the Arizona Department of Health Services and the University of Arizona College of Medicine for tracking and evaluation.
“The EPIC partnership across the state is allowing the implementation and evaluation of state-of-the-art treatment at the scene of an accident and is tracking how EMS care impacts the final outcome of patients,” said Dr. Daniel Spaite, professor of emergency medicine at the UA College of Medicine. “We know that treatment decisions immediately after a severe brain injury are critical. That response, in the first few minutes after TBI, may have more impact on how well a patient recovers than any treatment at a hospital or in rehabilitation.”
The national standards provide guidance for how to treat shock and best perform ventilations on TBI patients who are not breathing normally. These treatments are now considered “best practices” of TBI care and require special focus, training and equipment in the very challenging environment of care at an accident scene.
“Research has shown that things like blood pressure, oxygenation and ventilation have a profound impact on patient outcomes after TBI. These critical EMS interventions make a huge difference in survival,” said Dr. Ben Bobrow, medical director for the ADHS Bureau of EMS and Trauma System. “Part of EPIC is also getting technology into the hands of EMS providers to help them deliver these guidelines.”
Several special breathing devices help with the timing, force and depth of ventilation treatment; EPIC agencies can receive these devices for free, thanks to a donation from the Ramsey Social Justice Foundation. Unique cooperative partnerships like this have helped land Arizona the opportunity to implement and evaluate the national standards.
The state’s ongoing work on sudden cardiac death outside of the hospital has shown the nation that Arizona is unique in its cooperative ability to implement patient care improvements and evaluate the impact on patient outcomes. Because of this collaborative effort, the number of people who survive sudden death in Arizona has quadrupled in the past five years.
Find out if the EMS agency in your area is EPIC on the epic.arizona.edu website.