A fourth-grade teacher vaguely remembered hearing “If she makes it 20 minutes, we’ll talk.” A college student was clinically dead for 21 minutes. A man collapsed at Bojangles. A third-base coach fell face-first at Walnut Creek. A man giving a sermonette on Psalm 23 at a church event fell backward, just before reading “I will walk through the valley in the shadow of death.”

All suffered cardiac arrests.

Each told their story Wednesday night, thanking a crowd of Wake County emergency workers this week at the annual Cardiac Arrest Save Ceremony at the Progress Energy Center for the Performing Arts.

Even just a few years ago, some of them might not have been able to enjoy the festivities, which included Irish dancing and á Capella performances.

“There’s something about the immediate reversibility of this,” said Dr. Brent Myers, the director of Wake County Emergency Medical System. “These are people that literally were dead. And now they’re coming up here to tell their stories. And that kind of makes it all worth doing.”

Myers, at his post since 2002, started an initiative in 2005 to focus on cardiac arrests. Since then, survival rates have roughly tripled, according to a study published in “Annals of Emergency Medicine” magazine in October 2010.

In 2011, Wake medical professionals saved 74 lives of people who had heart attacks outside of a hospital. About 84 percent of those resuscitated walked out of the hospital. Brain damage is generally considered likely with as few as five minutes of heart stoppage.

Some of the changes in the data- and physiologically-driven initiative sound simple.

CPR protocol now emphasizes continuous chest compressions. Breathing, Myers said, is not as important as once thought during cardiac arrest. Also, moving patients can interrupt compressions and defibrillation, so Wake EMS aim to revive patients on site.

While those changes help survival rate by working on the heart, artificially induced hypothermia helps the brain. Wake EMS teams are using ice packs on the scene to cool victims, a measure that can improve brain function in survivors, according to Myers and multiple academic studies.

Wake County, along with EMS organizations in Seattle and Minneapolis, was among the first group to introduce the methods, and now Myers estimates that 20 of the biggest 30 EMS systems use similar protocol.

Still, Wake continues to stand out, with a 2011 survival rate to hospital discharge of 14.2 percent. That compares to the in the Cardiac Arrest Registry to Enhance Survival national average of 9.8 percent. Myers notes that data contribution is voluntary and those contributing have made heart attacks a priority.

According to the American Heart Association, 383,000 Americans suffer out-of-hospital heart attacks each year.

“Ten years or more ago, a lot of stuff was based on theory, what worked for the previous guy,” said 14-year Wake County EMS veteran and current training officer Shannon Holley. “But now what we do every day is data driven, more results driven.”

Eight of those results walked on stage at the end of the ceremony. Each told their story, and expressed extreme gratitude for the work of EMS personnel, and thankfulness to be alive.

And most of them echoed what Myers said was a near-universal sentiment among survivors – tomorrow is not guaranteed.

Jahner: 919-829-4822