Date of Award

2018

Document Type

Dissertation

Degree Name

Doctor of Health Administration

College

College of Health Professions

First Advisor

Walter J. Jones

Second Advisor

Howard A. Kirkwood

Third Advisor

Gwyndolan L. Swain

Fourth Advisor

James S Zoller

Abstract

In a 2016 County Profile, completed by the North Carolina State Department of Commerce, Caswell County had a population in 2014 of 23,614 and has a projected population for 2019 of 23,484. The population isn’t projected to increase, but the current population is aging. The quality of life for the residents in terms of healthcare is poor. According to this 2016 study, in 2013, Caswell County only had six physicians, the physicians per 10,000 populations was 2.5. Today, the County has three primary care physician offices, two in Yanceyville (the town seat) and one in Prospect Hill as well as the Health Department. The County also has ten volunteer fire departments that respond to medical calls to assist the County Emergency Medical Services (EMS) system, but the majority of them do not hold a North Carolina Office of Emergency Medical Services (i.e. Medical Responder, Emergency Medical Technician (EMT), Advanced EMT or Paramedic) certification. In North Carolina, fire and rescue department personnel are only required to have certifications if their respective departments require it. Caswell County currently has zero fire departments that are, at a minimum, providing EMT level care. Each department provides first responder assistance (these fire personnel have completed a 40 hour Emergency Medical Course) but do not possess a certification. The fire departments have not been approved by the current medical director to become EMT level departments, primarily because of the lack of providers, but also because of the internal training that must be done between the EMS system and the fire departments. There is an abundant need for additional training in the county to increase the level of care being delivered by the fire departments because as a rural county, with only three trucks operating twenty-four hours a day, seven days a week, there are times when the average response time for an ambulance can be over sixteen minutes. This delay in EMS response due to location of the ambulances compared to the location of the 911 calls impacts patient’s chances of survival greatly. This research project involves an analysis of data from January 1, 2014 through December 31, 2016 from Caswell County EMS, Caswell County Enhanced 911 Center, 10 the North Carolina Office of EMS Performance Improvement Center and the patient care reporting system that Caswell County EMS utilizes, known as ESO Solutions, Inc., on patients that received an AED prior to EMS arrival compared to patients that did not receive an AED prior to EMS arrival. Research Question and Hypothesis: The data consists of all patients that received cardiopulmonary resuscitation (CPR) from January 1, 2014 through December 31, 2016 in Caswell County. I will look at first responders and/or bystanders applying AEDs to patients in cardiac arrest and if an AED was not applied prior to EMS arrival with patients in cardiac arrest and their survival rate as well as patients that only had an AED applied by EMS and their survival rate. The research question that I’m posing is that survival rates would be higher if public access defibrillation programs were more accessible in non-Yanceyville areas. My hypothesis is those patients suffering from cardiac arrest that live in Yanceyville, NC have a better chance of survival than patients that live in other parts of Caswell County, referred to as non-Yanceyville due to the availability of AEDs.

Rights

All rights reserved. Copyright is held by the author.

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