Long Island too slow on heart attacks

Every year in Suffolk County, more than 900 people suffer cardiac arrest outside of a hospital. Only 2 percent or 3 percent survive.

But the national survival rate is around 8 percent, and some places do twice as well as that. If Suffolk could achieve the survival rate of the better performers, more than 100 lives could be saved annually. Nassau County, meanwhile, doesn't even have data on its performance in this life-and-death arena.

Both counties need to step up their game. While many factors contribute to regional variations in cardiac-arrest survival rates, one thing is clear: Saving more victims requires well-coordinated rescue efforts. "Many more people could potentially survive out-of-hospital cardiac arrest if regional systems of cardiac resuscitation were established," a group of experts said last year in a policy statement on behalf of the American Heart Association.

But on Long Island, as is so often the case, fragmentation rules. Cardiac-arrest victims here are subject to a patchwork of local providers, often trained volunteers, whose well-intentioned efforts aren't organized in the most effective way possible for saving lives.

In Suffolk, for example, there are more than 100 local ambulance corps, and some areas have their own dispatching systems. Response times vary -- but we don't know how widely, because data aren't kept. A Newsday study of dispatch records from 2005 found Long Island ambulance response times to be far longer than national standards.

While local Suffolk units cooperate to back one another up, a cardiac-arrest victim might have to wait for a home district ambulance even if a closer one is available in a neighboring community. As a start, stronger town-level coordination of emergency medical services would help.

In addition, not enough Long Islanders know CPR. Research shows that mere chest compression -- without mouth-to-mouth resuscitation -- saves lives, but only one in five Suffolk victims gets this precious help. In the Seattle area, where 16 percent of cardiac-arrest victims survive, CPR is three times as likely. The message is clear: Saving lives means teaching more Long Islanders CPR, so that bystanders can pitch in to keep a victim going until help arrives.

Suffolk emergency medical officials seem to be moving in the right direction. They are gathering data -- a crucial first step -- and speaking publicly about the problem. Stony Brook University is working to figure out whether people can learn rudimentary CPR from a one-minute TV commercial. And because cooling the body after cardiac arrest can dramatically improve survival and preserve more brain function, Stony Brook University Medical Center has acquired therapeutic hypothermia equipment. Not every hospital has it -- and more should.

The situation in Nassau County is murkier for want of information, but it too has a fragmented rescue system. As a start, Nassau must establish a data-gathering initiative to find out how well it's responding to cardiac arrest and what it needs to improve.

Saving more victims needn't cost much, but in both Suffolk and Nassau it will take leadership at the county level. Coordination is key, along with solid information on response times. In dealing with cardiac arrest, there's no time to waste.