Resident Eagle: Albuquerque`s Lifesaver Program

Resident Eagle is a new column authored by top EMS physicians and medical directors from the U.S. Metropolitan Municipalities EMS Medical Directors Consortium (the "Eagles"), who represent America’s largest and key international cities. Each month they will discuss the latest cutting-edge issues and findings in emergency care. 

Albuquerque has one of the most advanced EMS systems in the country. One of the programs its leaders are most excited about is its Lifesaver program. 

The Lifesaver program began as a cooperative agreement between Albuquerque Fire Rescue and the Albuquerque Police Department in 2013. Police were frequently first on scene at medical emergencies and recognized the need for training on initial lifesaving measures. The training has since evolved to include all types of community members. AFR holds classes in schools, churches, and other community centers while continuing to teach cadets at the police academy.

The First Five Minutes

In a life-threatening situation, the first five minutes are critical for survival. This is the time before paramedics even arrive. The people at the incident are in the best position to save lives. The foundation of Lifesaver training is the belief that most lay people will do anything in their power to help others in a tragic situation. We wanted to empower our citizens and recapture our sense of community. 

With the recent increases in mass shootings and opiate overdoses, it makes sense to equip people for these emergencies. Active-shooter incidents are on the rise, our state is experiencing an opioid epidemic, and cardiac arrest remains a leading cause of death. These are three areas in which our community members can make a difference. Unfortunately the percentage of citizens trained to provide first aid remains low. We are trying to change that. 

Specific Lifesaver training focuses on immediate life threats: cardiac arrest, life-threatening bleeding, and opiate overdose. By the end of the class, students become comfortable with AED use, hands-only CPR, Stop the Bleed, and naloxone administration. At the end of the course, everyone receives a certificate. Leaders are also developing “swag,” like stickers and other items to hand out, to help get the word out. 

Partnerships

When the idea came to the attention of Albuquerque Mayor Tim Keller, he loved it and mandated all 7,000 city employees receive the training. Keller even took the class himself. Capt. Stephany Perea, head of AFR’s EMS Training Division, coordinated with Tom Darling at the city learning center to schedule all city employees for the training. Now Lifesaver training will be included in every new-hire class for the city as well. AFR has also partnered with a local cardiologist and his program, Project Heart Start, which previously focused solely on hands-only CPR. 

Students who have taken the training report feeling much more prepared, comfortable, and willing to act in life-threatening emergencies. And they are: Last June a Lifesaver graduate witnessed a motorcycle accident just outside Santa Fe. The motorcyclist had a severe left leg injury with a possible arterial bleed and near amputation. Paramedics weren’t on scene yet. This trained bystander acted without hesitation and applied a tourniquet to the injured man’s leg, saving his life. 

Four months later a city employee attended a Lifesaver class. Two days later he applied his newly learned skills to help a 15-year-old boy who had been shot in his neighborhood. He recognized what needed to be done, applied direct pressure to the wounds, and effectively stopped the bleeding. 

Workers at a local homeless shelter who completed the Lifesaver class found a victim of opiate addiction who had overdosed in the shelter shower. They quickly recognized the signs and administered naloxone before EMS arrived. This was especially important because this particular shelter was outside city limits and almost 20 minutes from EMS response. In another instance the same workers performed the first 15 minutes of CPR and applied an AED before EMS arrival for a cardiac arrest. 

The city of Albuquerque has instituted city service aides who patrol the streets and check on people who are sleeping outside or appear homeless or intoxicated. Sometimes they find people who are in extremis and need immediate help. These CSAs have saved several lives by recognizing the signs of opiate overdose and administering naloxone. 

Training

Lifesaver training is predominantly conducted by AFR staff while on duty. Occasionally overtime or comp time is generated, but this is not the norm. AFR will implement a train-the-trainer course to include more employees from various city departments as instructors. This will allow us to teach more sessions without generating overtime. There is a plan in place for each city department to recertify on the training every three years, and this will rely on trainers within those organizations. 

After all city employees are trained, leaders plan to work with the Albuquerque public school system as well as expand to reach some of the state’s more rural areas.   

Kimberly Pruett, MD, is an assistant professor in the Department of Emergency Medicine at the University of New Mexico and medical director for Albuquerque Fire Rescue.

Stephany Perea is EMS Training Division captain for Albuquerque Fire Rescue.