Each year in Alameda County, EMS services responds to approximately 160,000 calls for service and about 1,200 of those calls for service are for Sudden Cardiac Arrest (SCA). Although this represents a fairly small portion of our overall call volume, this group of patients is considered the most critically ill of all. One of the top priorities of the Alameda County EMS Agency has been to improve the survival rates in our County for SCA events. We utilize a systems-based approach where we work to link all the various elements of our EMS system together to improve the outcomes of SCA patients. Read below to learn more about each of the elements that we use to ensure the best possible outcomes for this subgroup patients.
The utilization of the Medical Priority Dispatch System (MPDS) allows the dispatchers in Alameda County to work with 911 callers to quickly determine if a patient is suffering from SCA and thereafter provide them with instructions on performing CPR. This is critical because multiple studies have shown that when bystander CPR is performed, patients have the best chance of having a positive outcome.
To learn more about our Communication Centers and their usage of MPDS, visit our EMS System Page
Many jurisdictions in Alameda County utilize the PulsePoint mobile application. This application empowers our residents or visitors who are trained in CPR to be notified when they are nearby a reported SCA, so that they can potentially begin performing high-quality CPR.
To learn more about the PulsePoint Application, follow this link: PulsePoint Application
Automated External Defibrillators (AED) and Public Access Defibrillators
For a number of years, the Alameda County EMS Agency has been registering AEDs located in Alameda County and as of 2016, there are well over 2000 AED’s located throughout the County. Why is AED registration important when it come to SCA events? When an AED is registered with us, it allows us to notify our communication centers of the presence and location of each AED, which in turn can be utilized by dispatchers to direct bystanders to the nearest AED.Visit the EMS AED / PAD program to learn more.
While some of our First Responder Agencies were utilizing the Zoll Autopulse mechanical CPR device in 2011, Physio-Control’s LUCAS Device was deployed county-wide in November 2011.
Mechanical CPR provides consistent, sustained chest compressions to SCA patients and allows our field providers to focus on provision of other critical interventions.
To learn more about these devices and how they impact the management of SCA patients, follow the links below:
LUCAS Chest Compression System
ZOLL AutoPulse Resuscitation System
Obtaining vascular access can be an important part of successful resuscitation efforts. Venous access has been the traditional means of access for many decades, but can sometimes be difficult to perform, especially in the out-of-hospital setting. Since 2006, Alameda County has been utilizing intraosseous vascular access via the proximal tibial tuberosity and added the humeral head as an access site in 2017. Our ALS Providers typically utilize the EZ-IO vascular access system. This system allows vascular access to be obtained in a matter of seconds and medications/fluids to be delivered to the heart in a matter of seconds as well.
To learn more about the EZ-IO System that is utilized, follow the link below:
EZ-IO Intraosseous Vascular Access System
In 2009, we introduced the ResQPOD Impedance Threshold Device into our treatment algorithm for SCA. This device improves blood flow to the brain and other vital organs during cardiac arrest, enhancing the outcome of SCA events.
Learn more about the ResQPOD device by following the link below:
The ResQPOD® impedance threshold device
Since SCA is frequently secondary to the patient having a STEMI, our current protocols require that any patient being transported after an SCA event, will be transported to one of our seven STEMI Centers, which enables medical staff at those facilities to potentially treat the underlying cause of the SCA event through emergent cardiac catheterization.
One of the most important parts of improving outcomes for SCA patients is by collecting data and then analyzing it. Doing this allows us to discover, where we are doing well, what areas we need to improve, and which interventions that we employ are the most effective.