Medic One
Encyclopedia
The Seattle & King County Emergency Medical Services System is a fire-based two-tier response system providing prehospital basic and advanced life support services.
There are six paramedic provider programs in the system. The Seattle Fire Department operates Seattle Medic One. The program is funded by the city's general fund and has a different administrative structure than the five other Medic One programs. The five other Medic One programs with the exception of King County Medic One are operated by fire departments under a formal contract with the EMS Division of Public Health - Seattle & King County
. King County Medic One is directly operated by the EMS Division.
The modern EMS system in King County began operation in 1970 with 15 paramedics staffing one paramedic
unit in Seattle. In 2009 there are 255 paramedics from six paramedic programs staffing 26 paramedic units.
The system is a dynamic layered response system. An EMS response to an emergency begins with a telephone call to 9-1-1
. Calls are transferred from a primary call taker to emergency medical call taker
who gathers information from the caller, gives instructions to the caller, and determines what types of emergency personnel to send. For very serious and life threatening emergencies firefighter
s trained in basic life support
and paramedics trained in advanced life support
respond simultaneously. Paramedics transport patients in critical condition. For less severe emergencies only firefighters will be dispatched. Basic life support personnel from either a fire department or private ambulance company transport non-critical patients.
cardiologist Leonard Cobb proposed to the chief of the Seattle Fire Department
, Gordon Vickery, training firefighters to treat cardiac arrest. The department was attractive to Cobb because it already provided first aid and tracked its performance electronically.
In 1969, they trained fifteen firefighters and used a grant from the Washington/Alaska Regional Medical Program to convert a large motor home
into a Mobile Coronary Care Unit (nicknamed “Moby Pig”) which would respond to calls with both the firefighter paramedics and a physician on board.
The first Medic One call was on March 7, 1970 and during the program's first year, 31 lives were saved. The following year the program was changed, replacing the on-board doctors with fire department paramedics given advanced special training and remote access to the doctors.
In 1974, TV news-magazine, 60 Minutes
, profiled the success of Medic One, lauding the high standards of training and education provided by the Seattle training program. Correspondent
Morley Safer
declared, “If you have to have a heart attack, have it in Seattle.” A phrase still used frequently in conjunction with Medic One, due to its continued success which is reflected in the area's high survival rate for heart attacks and their comprehensive CPR training program.
That same year Medic One incorporated
as a privately held, non-profit organization
and established the Medic One Foundation, which works on behalf of both fund raising and the expansion of the program. The program is financed by local property tax levies, which are voted on by the public every six years, along with private and corporate donations.
Medic One service was expanded throughout King County in 1976 and, at that time, had been credited with saving the lives of 655 people who were clinically dead at the time paramedics arrived on scene. As the program's reputation grew, other counties in Washington State began adopting their own Medic One programs in conjunction with the Medic One Foundation.
In 1979, the program further evolved when Cobb worked with UW professor Mickey Eisenberg to start the training of fire department emergency medical technician - basics to administer defibrillation
treatment, as these EMTs are first on the scene, often arriving prior to the paramedics by several minutes. In 1982 a program was launched training 9-1-1 dispatchers to provide CPR instructions over the phone. The advent of automatic heart defibrillators in 1984 made it even easier for EMTs to treat heart attack victims.
. The paramedic medical director for Seattle Medic One is Michael Copass. The Seattle program conducts field internships for the University of Washington Paramedic Training Program.
. Its medical director is Tom Rea.
, training
, and quality improvement.
One of the primary components to the success of Medic One is their “Tiered Response System” which begins with the citizen call to the 9-1-1 center. Emergency Medical Dispatchers are trained to rapidly triage the call to dispatch the appropriate level of assistance, while providing pre-arrival instruction of CPR. Firefighters, with EMT training, respond first to deliver immediate Basic Life Support (BLS), pending the arrival of the paramedics. Specially trained paramedics arrive within minutes to provide Advanced Life Support (ALS) and, if needed, can provide transportation to the nearest appropriate Medical Center.
The system is successful due to the blended cooperation between the fire department and paramedic/ambulance services, as well as, a strict policy of meticulous measurement of system performance and cardiac arrest survival information. Strong leadership and regional programs promote uniformity in medical care and response, regardless of jurisdiction.
Another critical element to the Medic One program is the comprehensive training program for the paramedics, one of the most stringent anywhere, making their paramedics some of the most thoroughly trained in the world. Only paramedics with at least three years of prior firefighter or EMT experience may enter the program. Medic One paramedics receive 2,000 hours of instruction, using both “book” studies and hands on field and clinical application through both the University of Washington and Harborview Medical Center. The national standard for paramedic training is just 1,100 hours. Medic One paramedics will have more than 700 patient contacts during their training, which is three times the national standard. Upon completion of training Medic One paramedics are considered to be an extension of the ER doctors and may perform advanced medical care, open airways and administer a variety of medications
The final component is an emphasis on community based CPR training, called Medic Two. The Seattle/King County
area has the highest per capita number of citizens that are trained in the administration of CPR techniques, approximately 50% of its residents.
A medical 9-1-1
call is handled by one of the following communication centers Seattle Fire Department Alarm Center, Valley Communications Center, North East King County Regional Public Safety Communication Agency, Port of Seattle Police Department Communications Center, or Enumclaw Police Department Communications Center.
Medic One dispatchers use criteria based dispatch guidelines to send the most appropriate care providers. The three response levels are basic with advanced life support units, emergency BLS only, and non-emergency BLS only.
The first tier is basic life support
provided by cross-trained firefighter emergency medical technician - basics.
The second tier is advanced life support
.
Basic life support transports for 9-1-1 calls are provided by either a fire department or one of the private ambulance companies American Medical Response
and Tri-Med Ambulance. Advanced life support transports for 9-1-1 calls are provided by paramedics.
at Harborview Medical Center
and critical care unit and labor and delivery at Seattle Children's Hospital, and 900 field internship hours with Seattle Medic One. Students see an average of 700 patient contacts. Beginning in Fall 2010 new graduates of the training earned credits towards a Bachelor's Degree in Paramedicine from the University of Washington.
The Medic One Foundation is a nonprofit charitable foundation supporting paramedic training, research, medical oversight and quality review, and the purchasing of emergency medical equipment.
In King County outcomes of attempted out-of-hospital resuscitations are recorded, following the Utstein uniform reporting guidelines
, in a cardiac arrest registry. In 2008 Medic One's survival rate for witnessed cardiac arrests due to heart disease prior to EMS arrival with initial rhythm of ventricular fibrillation or ventricular tachycardia was 49%.
The average response time for basic life support personnel for cardiac arrests from time of 9-1-1 being dialed to arrival is 4 minutes 40 seconds and for advanced life support personnel is 9 minutes 45 seconds.
In 2008, 58% (530/920) of EMS-treated cardiac arrests not witnessed by EMS in Seattle & King County CPR was initiated by a bystander.
There are six paramedic provider programs in the system. The Seattle Fire Department operates Seattle Medic One. The program is funded by the city's general fund and has a different administrative structure than the five other Medic One programs. The five other Medic One programs with the exception of King County Medic One are operated by fire departments under a formal contract with the EMS Division of Public Health - Seattle & King County
Public Health - Seattle & King County
Public Health - Seattle & King County is the Public Health department that is jointly managed by the City of Seattle and King County governments serving approximately 1.8 million residents in King County, Washington State...
. King County Medic One is directly operated by the EMS Division.
The modern EMS system in King County began operation in 1970 with 15 paramedics staffing one paramedic
Paramedic
A paramedic is a healthcare professional that works in emergency medical situations. Paramedics provide advanced levels of care for medical emergencies and trauma. The majority of paramedics are based in the field in ambulances, emergency response vehicles, or in specialist mobile units such as...
unit in Seattle. In 2009 there are 255 paramedics from six paramedic programs staffing 26 paramedic units.
The system is a dynamic layered response system. An EMS response to an emergency begins with a telephone call to 9-1-1
9-1-1
9-1-1 is the emergency telephone number for the North American Numbering Plan .It is one of eight N11 codes.The use of this number is for emergency circumstances only, and to use it for any other purpose can be a crime.-History:In the earliest days of telephone technology, prior to the...
. Calls are transferred from a primary call taker to emergency medical call taker
Emergency medical dispatcher
An Emergency medical dispatcher is a professional telecommunicator, tasked with the gathering of information related to medical emergencies, the provision of assistance and instructions by voice, prior to the arrival of Emergency Medical Services, and the dispatching and support of EMS resources...
who gathers information from the caller, gives instructions to the caller, and determines what types of emergency personnel to send. For very serious and life threatening emergencies firefighter
Firefighter
Firefighters are rescuers extensively trained primarily to put out hazardous fires that threaten civilian populations and property, to rescue people from car incidents, collapsed and burning buildings and other such situations...
s trained in basic life support
Basic life support
Basic life support is the level of medical care which is used for patients with life-threatening illnesses or injuries until the patient can be given full medical care at a hospital. It can be provided by trained medical personnel, including emergency medical technicians, paramedics, and by...
and paramedics trained in advanced life support
Advanced Life Support
Advanced Life Support is a set of life-saving protocols and skills that extend Basic Life Support to further support the circulation and provide an open airway and adequate ventilation .-Components of ALS:These include:...
respond simultaneously. Paramedics transport patients in critical condition. For less severe emergencies only firefighters will be dispatched. Basic life support personnel from either a fire department or private ambulance company transport non-critical patients.
History
In 1968, motivated by the work of Frank PantridgeFrank Pantridge
Professor James Francis "Frank" Pantridge, MD, CBE was a physician and cardiologist from Northern Ireland who transformed emergency medicine and paramedic services with the invention of the portable defibrillator....
cardiologist Leonard Cobb proposed to the chief of the Seattle Fire Department
Seattle Fire Department
The Seattle Fire Department is the medical, rescue, and fire protection force of Seattle, Washington and it is the largest metropolitan fire department in the Pacific Northwest. It is also a part of Medic One.-History of the department:...
, Gordon Vickery, training firefighters to treat cardiac arrest. The department was attractive to Cobb because it already provided first aid and tracked its performance electronically.
In 1969, they trained fifteen firefighters and used a grant from the Washington/Alaska Regional Medical Program to convert a large motor home
Recreational vehicle
Recreational vehicle or RV is, in North America, the usual term for a Motor vehicle or trailer equipped with living space and amenities found in a home.-Features:...
into a Mobile Coronary Care Unit (nicknamed “Moby Pig”) which would respond to calls with both the firefighter paramedics and a physician on board.
The first Medic One call was on March 7, 1970 and during the program's first year, 31 lives were saved. The following year the program was changed, replacing the on-board doctors with fire department paramedics given advanced special training and remote access to the doctors.
In 1974, TV news-magazine, 60 Minutes
60 Minutes
60 Minutes is an American television news magazine, which has run on CBS since 1968. The program was created by producer Don Hewitt who set it apart by using a unique style of reporter-centered investigation....
, profiled the success of Medic One, lauding the high standards of training and education provided by the Seattle training program. Correspondent
Correspondent
A correspondent or on-the-scene reporter is a journalist or commentator, or more general speaking, an agent who contributes reports to a newspaper, or radio or television news, or another type of company, from a remote, often distant, location. A foreign correspondent is stationed in a foreign...
Morley Safer
Morley Safer
Morley Safer is a Canadian reporter and correspondent for CBS News. He is best known for his long tenure on the newsmagazine 60 Minutes, which began in December 1970.-Life and career:...
declared, “If you have to have a heart attack, have it in Seattle.” A phrase still used frequently in conjunction with Medic One, due to its continued success which is reflected in the area's high survival rate for heart attacks and their comprehensive CPR training program.
That same year Medic One incorporated
Incorporation (business)
Incorporation is the forming of a new corporation . The corporation may be a business, a non-profit organisation, sports club, or a government of a new city or town...
as a privately held, non-profit organization
Non-profit organization
Nonprofit organization is neither a legal nor technical definition but generally refers to an organization that uses surplus revenues to achieve its goals, rather than distributing them as profit or dividends...
and established the Medic One Foundation, which works on behalf of both fund raising and the expansion of the program. The program is financed by local property tax levies, which are voted on by the public every six years, along with private and corporate donations.
Medic One service was expanded throughout King County in 1976 and, at that time, had been credited with saving the lives of 655 people who were clinically dead at the time paramedics arrived on scene. As the program's reputation grew, other counties in Washington State began adopting their own Medic One programs in conjunction with the Medic One Foundation.
In 1979, the program further evolved when Cobb worked with UW professor Mickey Eisenberg to start the training of fire department emergency medical technician - basics to administer defibrillation
Defibrillation
Defibrillation is a common treatment for life-threatening cardiac arrhythmias, ventricular fibrillation and pulseless ventricular tachycardia. Defibrillation consists of delivering a therapeutic dose of electrical energy to the affected heart with a device called a defibrillator...
treatment, as these EMTs are first on the scene, often arriving prior to the paramedics by several minutes. In 1982 a program was launched training 9-1-1 dispatchers to provide CPR instructions over the phone. The advent of automatic heart defibrillators in 1984 made it even easier for EMTs to treat heart attack victims.
Programs
There are six paramedic programs in the Medic One system.| Paramedic program | Operated by | Paramedic units | Paramedics | Paramedic medical director | Service area(s) | Population served |
|---|---|---|---|---|---|---|
| Seattle Medic One | Seattle Fire Department Seattle Fire Department The Seattle Fire Department is the medical, rescue, and fire protection force of Seattle, Washington and it is the largest metropolitan fire department in the Pacific Northwest. It is also a part of Medic One.-History of the department:... |
7 | 78 | Michael Copass, MD | Seattle | 600,000 |
| King County Medic One | Public Health - Seattle & King County Public Health - Seattle & King County Public Health - Seattle & King County is the Public Health department that is jointly managed by the City of Seattle and King County governments serving approximately 1.8 million residents in King County, Washington State... |
8 | 71 | Tom Rea, MD | Auburn Auburn, Washington -Parks:Auburn has an extensive system of parks, open space and urban trails comprising 29 developed parks, 5 undeveloped sites under planning, 2 skate parks, 2 water roatary parks, and over of trails , and almost of open space for passive and active recreation.-Environmental Park:The Auburn... , Black Diamond Black Diamond, Washington Black Diamond is a city in King County, Washington, United States. The population was 4,151 at the 2010 census.Based on per capita income, one of the more reliable measures of affluence, Black Diamond ranks 64th of 522 areas in the state of Washington to be ranked.-History:Black Diamond was... , Burien Burien, Washington Burien is a city in King County, Washington, United States, located south of Seattle. As of the 2010 Census, Burien's population is 33,313, which is a 2.9% increase since incorporation. Annexation in 2011 has increased the cities population to about 45,000.... , Covington Covington, Washington Covington is a city in King County, Washington, United States. The population was 17,575 at the time of the 2010 census. Prior to the 2010 census, Covington was counted as part of Covington-Sawyer-Wilderness CDP.-History:... , Des Moines Des Moines, Washington Des Moines is a city in King County, Washington, United States. The population was 29,673 at the 2010 census. Property within the city has been the subject of land buyouts because of noise from aircraft landing or taking off from the Seattle-Tacoma International Airport two miles to the north of... , Enumclaw Enumclaw, Washington Enumclaw is a city in King County, Washington, United States. The population was 10,669 at the 2010 census.The Enumclaw Plateau, on which the city resides, was formed by a volcanic mudflow from Mount Rainier approximately 5,700 years ago.... , Federal Way Federal Way, Washington Federal Way is a city in King County, Washington, United States. Federal Way is located between Seattle and Tacoma. Its western boundary is Puget Sound. It is bordered by Des Moines on the north, Kent, unincorporated King County, and Milton on the east and Tacoma and Fife on the south... , Kent Kent, Washington Kent is a city located in King County, Washington, United States, and is the third largest city in King County and the sixth largest in the state. An outlying suburb of Seattle, Kent is also the corporate home for companies such as REI and Oberto Sausage... , Maple Valley Maple Valley, Washington Maple Valley is a city in King County, Washington, United States. The population was 22,684 at the 2010 census.-History:The area was first settled in 1879 by three men who were improving a trail and brought their families in. When a name for a future community was proposed, the names Vine Maple... , Pacific Pacific, Washington Pacific is a city in King and Pierce counties in the U.S. state of Washington. Located primarily in King County, the population was 6,606 at the 2010 census. Like its northern neighbor Algona, Pacific is sometimes mistaken for a part of Auburn.- History :... , Renton Renton, Washington Renton is an Eastside edge city in King County, Washington, United States. Situated 11 miles southeast of Seattle, Washington, Renton straddles the southeast shore of Lake Washington. Founded in the 1860s, Renton became a supply town for the Newcastle coal fields... , Seatac SeaTac, Washington SeaTac is an American city in southern King County, Washington, and an outlying suburb of Seattle, Washington. Incorporated in February 1990, the City of SeaTac is ten square miles in area and has a population of 26,909 according to the 2010 census... , Seattle-Tacoma International Airport Seattle-Tacoma International Airport The Seattle–Tacoma International Airport , also known as Sea–Tac Airport or Sea–Tac , is an American airport located in SeaTac, Washington, at the intersections of State Routes 99 and 509 and 518, about west of Interstate 5... , Skyway, Tukwila Tukwila, Washington Tukwila is a city in King County, Washington, United States. The northern edge of Tukwila borders the city of Seattle. The population was 19,107 at the 2010 census.-History:... , White Center White Center, Washington White Center is a census-designated place in King County, Washington, United States. It lies between Seattle and Burien part of which was annexed by Burien on 1 April 2010. The population was 13,495 at the 2010 census.-Geography:... |
700,000 |
| Shoreline Medic One | Shoreline Fire Department | 3 | 29 | Gary Somers, MD | Bothell Bothell, Washington Bothell is a city located in King and Snohomish Counties in the state of Washington. It is part of the Seattle metropolitan area. The population was 33,505 as of the 2010 census... , Shoreline Shoreline, Washington Shoreline is a city in King County, Washington, United States, north of Downtown Seattle bordering the northern Seattle city limits. As of the 2010 census, the population was 53,007, making it the 19th largest city in the state of Washington.... |
70,000 |
| Bellevue Medic One | Bellevue Fire Department Bellevue Fire Department The Bellevue Fire Department serves almost 120,000 Bellevue residents. It has 9 stations for its 237 employees.... |
4 | 36 | Jim Boehl, MD | 1-90 corridor, Bellevue Bellevue, Washington Bellevue is a city in the Eastside region of King County, Washington, United States, across Lake Washington from Seattle. Long known as a suburb or satellite city of Seattle, it is now categorized as an edge city or a boomburb. The population was 122,363 at the 2010 census.Downtown Bellevue is... , Mercer Island Mercer Island, Washington Mercer Island is a city in King County, Washington, United States and the name of the island in Lake Washington on which the city sits. The population was 22,699 at the 2010 census.... |
140,000 |
| Redmond Medic One | Redmond Fire Department | 3 | 31 | Adrian Whorton, MD | Duvall Duvall, Washington Duvall is a city in King County, Washington, United States, located on SR 203, halfway between Monroe and Carnation. The population was 6,695 at the 2010 census.-History:... , Kirkland Kirkland, Washington Kirkland is a city in King County, Washington, United States. It is a suburb of Seattle on the Eastside . The population was 48,787 at the 2010 census makes it the 9th largest city in King County and the 20th largest city in the state... , Redmond Redmond, Washington Redmond is a city in King County, Washington, United States, located east of Seattle. The population was 54,144 at the 2010 census,up from 45,256 in 2000.... , Woodinwille Woodinville, Washington Woodinville is a city in King County, Washington, United States. The population was 10,938 at the 2010 census. It is part of the Seattle metropolitan area. There is also a much larger population with Woodinville mailing addresses in adjacent unincorporated areas of King and Snohomish counties... |
104,000 |
| Vashon Medic One | Vashon Island Fire & Rescue | 1 | 7 | Sam Warren, MD | Vashon and Maury Island | 12,000 |
| Total | 26 | 255 | 1.8 million |
Seattle Medic One
Seattle Medic One is the paramedic provider program serving Seattle. It is operated by the Seattle Fire DepartmentSeattle Fire Department
The Seattle Fire Department is the medical, rescue, and fire protection force of Seattle, Washington and it is the largest metropolitan fire department in the Pacific Northwest. It is also a part of Medic One.-History of the department:...
. The paramedic medical director for Seattle Medic One is Michael Copass. The Seattle program conducts field internships for the University of Washington Paramedic Training Program.
King County Medic One
King County Medic One is the paramedic service serving all of South King County provided by Public Health - Seattle & King CountyPublic Health - Seattle & King County
Public Health - Seattle & King County is the Public Health department that is jointly managed by the City of Seattle and King County governments serving approximately 1.8 million residents in King County, Washington State...
. Its medical director is Tom Rea.
Structure
Founded on strong physician leadership Medic One is structured around responseEmergency management
Emergency management is the generic name of an interdisciplinary field dealing with the strategic organizational management processes used to protect critical assets of an organization from hazard risks that can cause events like disasters or catastrophes and to ensure the continuance of the...
, training
Training
The term training refers to the acquisition of knowledge, skills, and competencies as a result of the teaching of vocational or practical skills and knowledge that relate to specific useful competencies. It forms the core of apprenticeships and provides the backbone of content at institutes of...
, and quality improvement.
One of the primary components to the success of Medic One is their “Tiered Response System” which begins with the citizen call to the 9-1-1 center. Emergency Medical Dispatchers are trained to rapidly triage the call to dispatch the appropriate level of assistance, while providing pre-arrival instruction of CPR. Firefighters, with EMT training, respond first to deliver immediate Basic Life Support (BLS), pending the arrival of the paramedics. Specially trained paramedics arrive within minutes to provide Advanced Life Support (ALS) and, if needed, can provide transportation to the nearest appropriate Medical Center.
The system is successful due to the blended cooperation between the fire department and paramedic/ambulance services, as well as, a strict policy of meticulous measurement of system performance and cardiac arrest survival information. Strong leadership and regional programs promote uniformity in medical care and response, regardless of jurisdiction.
Another critical element to the Medic One program is the comprehensive training program for the paramedics, one of the most stringent anywhere, making their paramedics some of the most thoroughly trained in the world. Only paramedics with at least three years of prior firefighter or EMT experience may enter the program. Medic One paramedics receive 2,000 hours of instruction, using both “book” studies and hands on field and clinical application through both the University of Washington and Harborview Medical Center. The national standard for paramedic training is just 1,100 hours. Medic One paramedics will have more than 700 patient contacts during their training, which is three times the national standard. Upon completion of training Medic One paramedics are considered to be an extension of the ER doctors and may perform advanced medical care, open airways and administer a variety of medications
The final component is an emphasis on community based CPR training, called Medic Two. The Seattle/King County
King County, Washington
King County is a county located in the U.S. state of Washington. The population in the 2010 census was 1,931,249. King is the most populous county in Washington, and the 14th most populous in the United States....
area has the highest per capita number of citizens that are trained in the administration of CPR techniques, approximately 50% of its residents.
Leadership
Medic One is operated as a partnership between physicians and administrators. Medical directors review patient care by paramedics and can make recommendations including decertification and termination. Administrators act upon the recommendations of the medical director.Response
The major components of Medic One's response system are universal access, dispatcher triage, basic life support services, advanced life support services, and transport to hospitals.A medical 9-1-1
9-1-1
9-1-1 is the emergency telephone number for the North American Numbering Plan .It is one of eight N11 codes.The use of this number is for emergency circumstances only, and to use it for any other purpose can be a crime.-History:In the earliest days of telephone technology, prior to the...
call is handled by one of the following communication centers Seattle Fire Department Alarm Center, Valley Communications Center, North East King County Regional Public Safety Communication Agency, Port of Seattle Police Department Communications Center, or Enumclaw Police Department Communications Center.
Medic One dispatchers use criteria based dispatch guidelines to send the most appropriate care providers. The three response levels are basic with advanced life support units, emergency BLS only, and non-emergency BLS only.
The first tier is basic life support
Basic life support
Basic life support is the level of medical care which is used for patients with life-threatening illnesses or injuries until the patient can be given full medical care at a hospital. It can be provided by trained medical personnel, including emergency medical technicians, paramedics, and by...
provided by cross-trained firefighter emergency medical technician - basics.
The second tier is advanced life support
Advanced Life Support
Advanced Life Support is a set of life-saving protocols and skills that extend Basic Life Support to further support the circulation and provide an open airway and adequate ventilation .-Components of ALS:These include:...
.
Basic life support transports for 9-1-1 calls are provided by either a fire department or one of the private ambulance companies American Medical Response
American Medical Response
American Medical Response, Inc. or is an American provider of emergency and non-emergency medical transportation, operating in 38 states and the District of Columbia. It employs around 17,000 personnel and has a fleet of 4,400 vehicles...
and Tri-Med Ambulance. Advanced life support transports for 9-1-1 calls are provided by paramedics.
Education
All paramedics in King County are graduates of the University of Washington Paramedic Training Program regardless of previous training. The training is 1,866 total hours consisting of 380 lecture hours, 120 lab hours, 466 clinical hours in the operating room and emergency departmentEmergency department
An emergency department , also known as accident & emergency , emergency room , emergency ward , or casualty department is a medical treatment facility specialising in acute care of patients who present without prior appointment, either by their own means or by ambulance...
at Harborview Medical Center
Harborview Medical Center
Harborview Medical Center, located on Seattle's First Hill, is a public hospital in King County, Washington and is managed by UW Medicine.-Overview:...
and critical care unit and labor and delivery at Seattle Children's Hospital, and 900 field internship hours with Seattle Medic One. Students see an average of 700 patient contacts. Beginning in Fall 2010 new graduates of the training earned credits towards a Bachelor's Degree in Paramedicine from the University of Washington.
Improvement
The paramedic medical director for the one of six Medic One programs that provided care reviews every resuscitation, intubation, and central-line placement attempt. That director provides both positive and negative feedback. For probationary paramedics a more rigorous review is conducted.Funding
Medic One paramedic programs are funded by a property tax levy. Basic life support services receive partial funding from the levy. The levy passed in 1979, 1985, 1991, 1998, 2001, and 2008. The levy did not pass in 1997.The Medic One Foundation is a nonprofit charitable foundation supporting paramedic training, research, medical oversight and quality review, and the purchasing of emergency medical equipment.
Cardiac Arrest
A change in the protocol of emergency response personnel is also credited as contributing to the high survival rate in the region. Guidelines set by the American Heart Association in 2000, recommend repeated shocks from a defibrillator and to check for a pulse prior to starting CPR. Medic One guidelines, established in 2005, are to provide a single shock from a defibrillator followed immediately by two minutes of CPR, beginning with chest compressions. This has dropped the average time between first shock to starting CPR from twenty-eight seconds to seven seconds, resulting in a near 50% increase in the previous rate of survival. For every one-hundred cardiac arrest calls, now an additional thirteen patients will live.In King County outcomes of attempted out-of-hospital resuscitations are recorded, following the Utstein uniform reporting guidelines
Utstein Style
The Utstein Style is a set of guidelines for uniform reporting of cardiac arrest. The Utstein Style was first proposed for emergency medical services in 1991...
, in a cardiac arrest registry. In 2008 Medic One's survival rate for witnessed cardiac arrests due to heart disease prior to EMS arrival with initial rhythm of ventricular fibrillation or ventricular tachycardia was 49%.
| 2005 | 2006 | 2007 | 2008 | |
|---|---|---|---|---|
| All | 17% (190/1124) | 18% (174/993) | 18% (191/1035) | 19% (199/1046) |
| Ventricular Fibrillation/Tachycardia (VF/VT) | 30% (132/436) | 40% (125/310) | 40% (120/302) | 47% (151/323) |
| Before EMS Arrival | 16% (164/1015) | 17% (145/875) | 16% (143/899) | 17% (160/920) |
| VF/VT | 29% (113/386) | 36% (100/279) | 36% (97/267) | 39% (112/286) |
| Bystander Witnessed VF/VT Due to Heart Disease | 45% (86/193) | 41% (80/196) | 45% (84/188) | 49% (102/208) |
| Asystole | 1% (6/473) | 1% (5/335) | 2% (6/346) | 2% (8/354) |
| Pulseless Electrical Activity (PEA) | 12% (18/155) | 15% (38/253) | 14% (39/281) | 14% (39/277) |
| Unknown | 100% (1/1) | 25% (2/8) | 33% (1/3) | 25% (1/4) |
| After EMS Arrival | 24% (26/108) | 25% (29/118) | 35% (48/136) | 31% (39/126) |
| VF/VT | 38% (19/50) | 48% (15/31) | 66% (23/35) | 62% (23/37) |
| Asystole | 25% (4/16) | 7% (1/14) | 26% (5/19) | 16% (2/12) |
| PEA | 7% (3/41) | 19% (13/70) | 24% (20/82) | 18% (14/78) |
| Unknown | 0% (0/1) | 0% (0/3) | (0/0) | (0/0) |
The average response time for basic life support personnel for cardiac arrests from time of 9-1-1 being dialed to arrival is 4 minutes 40 seconds and for advanced life support personnel is 9 minutes 45 seconds.
In 2008, 58% (530/920) of EMS-treated cardiac arrests not witnessed by EMS in Seattle & King County CPR was initiated by a bystander.
Endotracheal intubation
Seattle Medic One's first-pass success rate for oral endotracheal intubation is 75% (years 2001–2005). Its overall success rate is 98.4%.Research
- Cardiac Arrest Blood Study (CABS)
- AutoPulseAutoPulseThe AutoPulse is an automated, portable, battery-powered cardiopulmonary resuscitation device created by Revivant and subsequently purchased and currently manufactured by ZOLL Medical Corporation...
Assisted Prehospital International Resuscitation (ASPIRE) Trial - Transthoracic Incremental Monophasic Versus Biphasic by Emergency Responders (TIMBER)
- Dispatcher-Assisted Resuscitation Trial (DART)
- Emergency Medical Technician Treatment of Hypoglycemia in the Field
- Induced Hypothermia for Cardiac Arrest Patients
- Resuscitation Outcomes ConsortiumResuscitation Outcomes ConsortiumThe Resuscitation Outcomes Consortium is a network of eleven regional clinical centers and a data coordinating center. The consortium conducts experimental and observational studies of out-of-hospital treatments of cardiac arrest and trauma....
- SPHERE Hypertension Intervention Study
- At-Home Automated External Defibrillator (AED) Training Study