UW News

May 13, 2010

Emergency medical services save lives when minutes count

Carol Mathewson could not have imagined that her life would soon be hanging in the balance when she entered Lake Washington for the 2008 Danskin Triathlon. Despite being in peak physical condition, the 56-year-old woman went into sudden cardiac arrest and began disappearing under the water.


The American Heart Association estimates that more than 95 percent of cardiac arrest victims die before reaching the hospital. Fortunately, survival rates improve when early cardiopulmonary resuscitation (CPR) and rapid defibrillation are provided in combination with advanced pre-hospital medical care.


Thanks to the quick response of emergency medical technicians and paramedics, Mathewson was one of these survivors. A pair of event volunteers, who were trained in basic life support, got her ashore and began performing CPR. Two bike paramedics quickly arrived to provide advanced life support until she could be taken to Harborview Medical Center. Three days later, she awoke from a coma and began a grueling but successful recovery.


For more than 40 years, Seattle and King County have been home to a pioneering system for delivering emergency medical services. The system got its start when Dr. Leonard Cobb, UW professor of cardiology, and the late Seattle Fire Chief Gordon Vickery established the Seattle Medic One program at Harborview in the late 1960s.


Early milestones included the training of the first class of firefighters as paramedics (1970) and the first mass training of citizens in CPR (1972). Called Medic 2, this effort was organized by Dr. Cobb and provided instruction to more than 100,000 people during its first two years. In 1974, these programs gained national prominence when a correspondent on CBS 60 Minutes famously stated: “If you have to have a heart attack, have it in Seattle.”


Today, King County continues to set the standard for paramedic training and pre-hospital emergency care in the United States and worldwide. Its 1.8 million residents are served by a network of dispatch centers, paramedic providers (Bellevue Medic One, Redmond Medic One, Seattle Medic One, Shoreline Medic One, South King County Medic One and Vashon Medic One), fire departments and hospitals that provide a continuum of care for people in need of emergency medical services.


The continuum begins with universal access to medical care through 9-1-1. The 9-1-1 number allows all telephone calls to be immediately connected to a dispatcher. Once a call has been received, dispatchers use specific dispatch triage guidelines to determine the level of care required. In life-threatening situations, such as cardiac arrest, paramedics providing advanced life support services respond to the scene. In less urgent cases, such as a fractured leg, emergency medical technicians providing basic life support services respond to the call. After the patient is stabilized, hospital transport is provided if further medical treatment is needed.


The county has more than 280 certified paramedics, who learn lifesaving skills directly from UW School of Medicine physicians at Harborview. In 2007, Seattle and King County firefighters and paramedics responded to more than 172,000 emergency medical calls, including 51,000 that required advanced life support treatment by paramedics.


Community-based programs have been established to educate residents about the “Chain of Survival” for cardiac arrest: early 9 1 1 access, early CPR and early defibrillation. These programs can help save a family member by teaching you how to give CPR and how to use an automatic external defibrillator. They also provide information on recognizing medical emergencies, calling 9-1-1 for medical assistance, injury prevention, health education and disaster preparation.


Emergency Medical Services week will be observed May 16-22 to show appreciation for the lifesaving work of paramedics and emergency medical technicians and to promote public education and safety programs. For more information about King County’s community-based medical emergency programs, visit its EMS website.