Recently, fourteen New Hampshire communities were designated as HEARTSafe by the New Hampshire Bureau of EMS, their Department of Public Health and the American Heart Association after taking part in an effort to improve response, care and outcomes for victims of cardiac arrest. These communities have increased the number of residents skilled in CPR, educated them about the importance of quick response and have strategically deployed automated external defibrillators, among other measures. In recognizing these local achievements, the towns are provided with HEARTSafe Community road signs. Related article: http://www.wmur.com/health/30483785/detail.html#ixzz1mqJQ3pnA But what does this mean? Let’s start by looking at the populations of the communities, the annual projected number of cardiac arrests, and estimated survival rates at 5%, 10%, and 20%.

1. Recently, fourteen New Hampshire communities were designated as HEARTSafe by the New
Hampshire Bureau of EMS, their Department of Public Health and the American Heart
Association after taking part in an effort to improve response, care and outcomes for victims of
cardiac arrest.
These communities have increased the number of residents skilled in CPR, educated them
about the importance of quick response and have strategically deployed automated external
defibrillators, among other measures. In recognizing these local achievements, the towns are
provided with HEARTSafe Community road signs.
Related article: http://www.wmur.com/health/30483785/detail.html#ixzz1mqJQ3pnA
But what does this mean? Let’s start by looking at the populations of the communities, the
annual projected number of cardiac arrests, and estimated survival rates at 5%, 10%, and
20%.
Chester, NH Population: 4,800
Concord, NH Population: 43,000
Goffstown, NH Population: 18,000
Henniker, NH Population: 4,800
Hudson, NH Population: 24,500
Keene, NH Population: 23,500
Lancaster, NH Population: 3,500
Peterborough, NH Population: 6,300
Portsmouth, NH Population: 21,200
Rochester, NH Population: 29,800
Swanzey, NH Population: 7,200
Walpole, NH Population: 3,700
Woodstock, NH Population: 1,400
Combined population of above communities: 191,700
Anticipated number cardiac arrests (annual): ~190
Number surviving (5% survival rate): 9
Number surviving (10% survival rate): 19
Number surviving (20% survival rate): 38

2. As I have mentioned, along with countless others, communities must be recognized as “ultimate
coronary care units”. By doing so, we can take some relatively simple steps to effectively
increase survival and improve outcomes from sudden death. Community wide interventions that
will improve overall resuscitation quality and increase the likelihood of early bystander initiated
CPR and prompt defibrillation are critical aspects of any effort to reduce death and disability
from out-of-hospital cardiac arrest.
An optimal strategy is one that actively engages a community at all levels. HEARTSafe programs
have effectively advanced a full spectrum of survival priorities spanning signs and symptoms,
EMD, bystander CPR, early defibrillation strategies (including LEA), early STEMI identification,
ACLS education, and more.
HEARTSafe Community Programs are population and criteria based incentive programs that are
designed to help municipalities of all sizes to plan, develop, and implement chain of survival and
systems change strategies.
This link http://tinyurl.com/3zjxcjm will help you access programs so you can examine
unique program attributes relating to interagency collaboration, media engagement and best
practices in application. Our goal is to expose more people to the concept of HEARTSafe and
inspire and enable them to design, implement and promote similar strategies in more locations
across the world.
Fully 50% of men and women in western society with serious coronary artery disease
experience their first signs of the disease in a dramatic way—sudden cardiac arrest.
Whether a victim lives or dies at this point depends on whether the collapse is witnessed, if the
people who are there are trained and WILLING to perform CPR, and whether the arrest has
occurred in a system that can bring about early arrival of needed resources and execution of
evidence based (timely) interventions.
Many have recognized the need to improve community systems of emergency cardiovascular
care to optimize patient survival. The "Chain of Survival" represents the current approach to
improving recognition, response, care and outcomes.
Decades later, this same systematic, organized, coordinated effort in a community remains the
strongest recommendation the resuscitation community can make to save more people from
out-of-hospital cardiac arrest (although I have no business being a “representative of the
collective opinion” of the resuscitation community).
The central question to be answered is whether a community’s system exploits resources and
implements measures and strategies to achieve optimal (and attainable) patient survival.
I find that there are numerous systems where implementation of modifications aimed at
optimizing treatment for patients has lead to improved outcomes for critical out-of-hospital
patients. I believe that concepts and programs such as the Heart Rescue program and
HEARTSafe Communities are essential frameworks for utilization by any group looking to
advance related strategies to improve survival, systems and quality of life.

3. New treatments have improved the possibility of survival from cardiovascular emergencies and
cardiac arrest offer the hope of improved quality of life for people who suffer these events.
Community based CPR efforts and education are needed in as many locations as possible.
Experience supports the value of early CPR by citizens and a community approach to supporting
and guiding systems development.
Strategies like HEARTSafe help to remove barriers that discourage development of
comprehensive strategies to enhance survival probability and aid in creating community-wide
change.