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Center for the Evaluation of Emergency Medical Services

The Center for the Evaluation of Emergency Medical Services (CEEMS) undertakes research efforts in the field of pre-hospital emergency care. CEEMS is supported by grants and staffed by investigators from the University of Washington and employees of the EMS Division. Known both nationally and internationally in the field of cardiac arrest, the investigators are continuously sharing their cutting edge research through numerous articles published in EMS and scientific journals.

The co-directors of CEEMS are Mickey Eisenberg, MD, PhD; Peter Kudenchuk, MD; Hendrika Meischke, PhD; Tom Rea, MD, MPH.

A summary of the primary CEEMS activities is as follows:

The DART Study: The Dispatcher Assisted Resuscitation Trial (DART) is an international study involving dispatch centers in King County, Thurston County, and London, England. The study will determine the best method of telephone CPR: standard CPR with chest compressions and mouth-to-mouth ventilation or chest compressions only. The study will take approximately 2-1/2 years to complete and may serve to define the national standard for the delivery of telephone CPR instructions.

AED trainingHome Automated External Defibrillator (AED) Training of High-Risk Patients: This study is funded by the National Institutes of Health (NIH) and began in July 2004. The randomized study is evaluating 4 types of AED training (2 video-based training and 2 in-home training) in 300 high-risk heart patients and their families recruited following hospitalization at a King County hospital for a heart emergency. The study will determine the most effective training method in terms of AED skills retention and psychological adjustment for both the patient and family member(s). Participants receive an AED and lifesaving skills training at no cost as part of study. Enrollment will continue through 2007.

Medical Outcomes after Cardiac Arrest: This investigation involves interviewing survivors of cardiac arrest and reviewing their hospital medical records. The goal is to evaluate the care and outcome of survivors of cardiac arrest in King County to determine whether current hospital-based care is consistent with American Heart Association and American College of Cardiology guidelines for these patients. The study will run through 2007.

The Resuscitation Outcomes Consortium (ROC): The Resuscitation Outcome Consortium was established in 2004 by the National Heart, Lung, and Blood Institute to evaluate important research questions involving pre-hospital care in the areas of cardiopulmonary arrest and life-threatening injury. The ROC consists of 10 communities from across North America. Seattle/King County has been selected as one of the participating communities. Clinical trials will be conducted over several years to evaluate promising approaches to improving outcomes from cardiac arrests and traumatic injuries. The first trauma-based study will involve a randomized clinical trial to evaluate what resuscitation fluid produces best outcome for traumatic shock and head-injured patients. The first cardiac-based study will involve a randomized trial of an impedance threshold device that may improve circulation produced by CPR.

Supporting Public Health with Emergency Responders (SPHERE): This project provides important health information back to patients seen by emergency responders during a 9-1-1 call. If a potential health risk is identified, such as high blood pressure or a high blood sugar level (a possible indication of diabetes), the EMS system alerts the patient to seek further follow-up. By identifying factors that can lead to chronic health problems, the EMS system is assisting the Public Health Department to improve the health and wellbeing of its citizens.

Paramedic Fellowship: Thanks to funding support from the Laerdal Foundation for Acute Medicine, CEEMS is offering paramedic fellowships for the purpose of conducting research. This is the first program of this nature in the country. The program offers special opportunities for paramedics under the guidance of a UW faculty mentor. The first paramedic fellow began the program in July 2005. The two year-long project will be an in-depth analysis of central intravenous lines for critically ill patients.

Graduate Student Research Assistant: Thanks also to funding support from the Laerdal Foundation for Acute Medicine, a PhD student in epidemiology will be joining CEEMS and be spending 50% of her time assisting in projects and research studies.

Medical Student Projects: CEEMS sponsors approximately 10 students per year who are completing a medical school graduation requirement to conduct a research project. Each student is assigned a faculty mentor who helps the student design the project and develop the methodology. We have been fortunate in that approximately 80% of these research projects are published in peer-reviewed scientific journals.