Civilian Response Teams: Neighbors Help Neighbors

     Proactive managers know the benefits of community participation within their services, and successful systems often develop programs for outreach and to encourage people outside the service to get educated and involved with it. Most of these programs are designed and implemented by staff members, such as a fire marshal reaching out with information and activities during Fire Prevention Week, or paramedics performing educational programs during EMS Week. But some of the best ideas for participation come through people in the community, not at fire or EMS headquarters. Programs where citizens identify a need, formulate a plan and act on their ideas often yield amazing results.

     A benchmark example exists in Florida, at a place called The Villages. Located near Ocala, The Villages is a planned adult community that eventually will cover over 100 square miles. Its name is derived from its structure: Many "village" communities are built around a central infrastructure, which includes fire and EMS funded with fees paid by residents to a Community Development District. Lew Simon, a resident and EMS/fire volunteer, saw the need for community involvement in cases like sudden cardiac arrest and choking—involvement that could reflect basic principles of emergency care.

     Fire department ALS response in The Villages is excellent, with rapid response times. However, Simon knew that even quick ALS responses to cardiac arrests may not be fast enough, so he figured out a plan. With the support of The Villages' fire chief, 34 people from one Village were trained in CPR and AED operation. Two AEDs were purchased from voluntary contributions to help equip a Civilian Response Team. Every homeowner in this Village contributed. The AEDs were mounted in waterproof containers outside residents' homes at opposite ends of the Village's main circle road.

     The next step in the process was communications. Without a method to notify neighbors of medical emergencies in a timely fashion, the program was doomed to failure. After a meeting with Lake-Sumter EMS dispatch staff, a simple but effective network was established. Using their CAD software, dispatch personnel were able to program their system with "alerts" that pop up when specific addresses are entered. The cadres of CPR/AED-trained residents were provided alphanumeric pagers purchased with leftover funds from the AED collection. When an alert location is recognized at dispatch, the call-taker or dispatcher can select a menu option to activate the pagers with predetermined messages. This information includes the address and the emergency. Residents typically respond via golf carts and fetch an AED from one of the two storage locations. They do not provide any higher level of care than BLS CPR and AED. The intention was not to have home-based pseudo-EMTs, but rather to get CPR-trained persons with AEDs to patients' sides quickly.

     The system works. With fire-rescue administrators and the EMS medical director (who fully supported the program) present, program architects performed a test. They placed a manikin on the front lawn of a home, and the communication center sent out a page. Within 40 seconds of the initial simulated 9-1-1 call, a nearby neighbor came from his home and verified a person was down. He initiated CPR. Moments later, two others arrived via golf cart, having retrieved the nearest AED. They delivered three simulated shocks before fire-rescue arrived.

     This program has rapidly expanded in three short years. The 34 initial volunteers now number around 190, spread across several other Villages within the community. Each participating Village has a minimum of two AEDs, with some larger areas sporting six. All are readily accessible to the response-team volunteers. New people are being trained on a regular basis by both Simon and The Villages Fire Department. Also, other communities outside The Villages have expressed interest in developing comparable programs.

     There is no doubt community outreach by EMS and fire agencies can serve to educate the public and help emergency responders with many projects. However, the pubic responding in kind can also make a real difference. In The Villages, the grass roots are alive and well and committed to helping each other on a daily basis. For more information, contact Simon at 352/751-0441 or avline@aol.com.

Tom Batchelor is a fire-lieutenant/paramedic with Longboat Key Fire-Rescue in Longboat Key, FL.