Background
King County EMS started to explore the concept of early defibrillation in the mid to late 1970s. Dr. Mickey Eisenberg was interested, along with Dr. Leonard Cobb, in the concept of using these unique machines in Aid Cars of the local fire departments.
King County EMS began studies to assess patient outcome in specific situations. At this time, we had specific areas with Medic One units as well as geographic areas without Medic One units. This was a perfect scenario to ascertain the patient outcome with defibrillation and ALS services and without ALS services. The data compiled was interesting, to say the least. Outcome without early defibrillation was minimal -- less than 8% survival. With early defibrillation and no ALS services the survival rate was 26%. With early defibrillation and ALS services the survival rate was 38%.
We recognized the importance of early CPR to improve patient outcome for cardiact arrests. Along with the Medic 2 program we initiated citizen CPR and dispatcher assisted CPR.
With this data in hand, we recognized that in order to give the best care to the citizens of King County we needed to add early defibrillation training to the EMTs of King County. Defibrillation was added to the EMT classes in the 1980s. We were the first EMS division in the world to recognize the importance of EMTs and First Responders in providing early defibrillation and an increase in patient survival rates.
Dr. Richard Cummins took the lead, and with his help we also changed the American Heart Association's protocol for CPR.
We are continuing to help improve our patients' survivability to this lethal situation. We continue to gain data and are looking for better responses from our aid cars. In adding Public Access Defibrillation (PAD), we expect to see even better results in the future.
We are saving 36% of all patients found in Ventriculation Fibrillation (VF) sudden death. Compared to cities that save 3-4%, this is exceptional. It comes from hard work and continuing education of the firefighters and paramedics of this county.
King County EMS - Early Defibrillation Program
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The overall goal of the Early Defibrillation Program is to resuscitate the greatest number of persons from sudden cardiac arrest. The program reaches this goal by meeting the following program objectives:
- Provide centralized medical direction and program resources
- Provide clear, concise standing orders while allowing the EMT-D/FR-D to utilize sound medical judgment when appropriate
- Conduct consistent, effective, and scenario-based initial defibrillation training
- Provide instructors with current information and effective training tools with annual refresher training
- Maintain adequate skill levels through consistent, periodic continuing education
- Ensure program quality improvement through field event quality assurance and continuous program improvement
- Promote the consistent use of well-maintained defibrillation equipment
The specific goals of the Defibrillation Standing Orders are:
- Ventricular Fibrillation (VF) is to be shocked repeatedly and as rapidly as possible
- Effective CPR is to be performed and interrupted for a minimum time
- Overall patient care and safety are never to be neglected
The Automated External Defibrillation training course requires approximately four hours of classroom and practical training, provided by King County EMS (or a fire department local course director that has been approved by KCEMS). Practical training for this course is scenario based. The EMT-D is required to attend a defibrillation Continuing Education (CE) session during each quarter of a twelve-month period.
The Defibrillation Quality Assurance Coordinator reviews recordings of field cardiac arrest events. An assessment of the overall performance for each VF case reviewed, including any noted areas requiring improvement or additional training, is sent to the agency's Training Officer (or other designated person). When trends or frequently observed performance concerns are noted during event recording reviews, the Training Coordinator is informed of such concerns, in order to identify methods of improving performance throughout the program.
Emergency Medical Services
999 3rd Avenue, Suite 700
Seattle, WA 98104
Phone: 206-296-4693
Fax: 206-296-4866
Click here to send us an email.
We offer two EMT-B classes per year, designed primarily for members of King County fire agencies. Our EMT classes are 120 hours of classroom and practical work with 10 hours of hospital observation time. These classes are held in fire stations in the Spring and Fall of each year. Information regarding eligibility and class schedules can be obtained from your sponsoring agency.
Are you interested in becoming an EMT in King County? Are you an EMT from another part of the state or an out of state EMT and would like to transfer your skills to this beautiful part of Washington State? We have the answers and requirements necessary to do just that.