The Wake County EMS System and the Chain of Survival
 
In Wake County, more than 20% of SCA victims survive to discharge from the hospital, compared with an average of 5 to 7% nationwide. While the 20% survival rate certainly demonstrates many areas of success, the System is constantly seeking ways to save even more lives. In cities such as Boston and Seattle, where optimal implementation of all links in the chain of survival has occurred, discharge rates in the 30 to 40% range have been achieved. The current status and future plans regarding each link is described below.
 
Early Access:
 
Current Status:
 
  • Enhanced 9-1-1 emergency services in three Communication Centers
  • Emergency Medical Dispatchers (EMDs) in all 9-1-1 centers who are trained to guide callers through performance of CPR and the use of AEDs while awaiting EMS arrival
  • Upgraded Computer-Assisted Dispatch (CAD) technology that expedites notification of the EMS Station nearest a request for service
Planned Improvements:
 
  • Incorporation of AED locations into the CAD. In this way, EMDs can direct callers to the exact location of an AED and guide them through the use of the device.
Early CPR:
 
Current Status:
 
  • Citizens are instructed in CPR by Emergency Medical Dispatchers in 9-1-1 centers.
  • All fire departments in Wake County provide well-trained first responders capable of CPR and AED use.
Planned Improvements:
 
  • Coordination of community CPR educational opportunities with the American Heart Association, local hospitals, and other groups
Early Defibrillation:
 
Current Status:
 
  • All fire departments in Wake County provide well-trained first responders capable of CPR and AED use.
  • RexHealthcare Emergency Response Team provides medical personnel and AEDs for major events.
  • Wendell Police Department carry AEDs on patrol and provide rapid response for victims of SCA.
  • Some public venues have AED programs in place.
Planned Improvements:
 
  • Evaluation of additional non-traditional responders for use of an AED (e.g., security guards, other law enforcement agencies, etc.)
  • Analysis of historical SCA data in order to recommend placement of AEDs in high-risk areas through the community
  • Coordination of AED sales, training, registration of AED locations, and data gathering for 9-1-1 centers
Early Access to Advanced Care:
 
Current Status:
 
  • Uniform response of highly trained Advanced Life Support personnel from all agencies in the Wake County EMS System
  • Focus on cardiac arrest care in an on-going quality assurance process
  • Emphasis on state-of-the-art treatment modalities based on the best medical evidence available
 
Planned Improvements:
 
  • Re-evaluation of all treatment modalities on a regular basis to ensure treatment is being guided by best evidence
  • Increased involvement of EMS personnel in community education