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Missing AEDs, Heroic Service and King County’s Impressive Survival Rate

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Where's the AED?
It’s disheartening to spot an AED wall unit that doesn’t actually have an AED in it, but to see the lifesaving tool missing from facilities in two different countries? Yikes!

  We give a big thumbs down to Aruba International Airport (photo 1) and a ferry terminal in New England (photo 2) for having empty AED wall units.

  Thumbs up, though, to the San Francisco International Airport (right) for appropriately tagging and stocking its AED stations.

  Heroic Service
When attending to an accident, firefighters are often given specific roles: scene management, extrication, patient care. But on Jan. 30, 2013, in Prince George’s County (Md.), firefighter/paramedic Sara A. Shaffer embraced all three when she and her crew responded to a three-vehicle accident on the Capital Beltway.

The wreckage involved an SUV, semitruck and a fire/EMS engine. The fire engine manned by four firefighters was rear-ended by the semi, overturned and spun 180 degrees.

As Shaffer approached the engine, she saw that three of the firefighters had removed themselves safely through the engine’s windshield. However, the fourth firefighter, Ryan Evans, was still trapped inside—his right arm all but detached from his torso.

Shaffer removed debris that pinned him from the waist down and positioned him so his own body weight would control the bleeding from his arm until a tourniquet was applied.

She then took a backboard from an ambulance and instructed the extrication crew to use it to slide Evans up and over the engine’s seats, and then through the windshield and onto a stretcher. During the process, Shaffer used her body to stabilize the space between the engine’s house and the cab’s roof so the crew could extricate Evans safely.

Once Evans was out, Shaffer joined him in the ambulance. The tourniquet was removed from his arm and she clamped her hands onto his brachial artery to prevent him from bleeding out. The act ultimately saved Evans and his arm.

It’s no wonder, then, that Shaffer, an eight-year veteran of Prince George’s Fire/EMS Department was awarded the county’s Gold Medal of Valor as well as named Firefighter of the Year.

We congratulate Shaffer and give her a thumbs up for her ingenuity, selflessness and quick thinking.

  Record Setters
In 2013, the EMS/Medic One program of King County, Wash., achieved the nation’s highest survival rate from cardiac arrest. Whereas the American Heart Association reports a national survival rate of 9.5%, King County reports 62%. According to the agency, it’s the result of a coordinated effort to guide dispatchers, first responders, fire departments, law enforcement, urgent care centers and local residents with top-notch medical direction and evidence-based practices.

In addition to seeing high rates of CPR training offered to King County citizens, strategies that contributed to the system’s success include the adoption of high performance CPR focused on minimal breaks in compressions, full chest recoil, adequate compression depth and rate combined with the adoption of telecommunicator CPR, whereby 9-1-1 emergency personnel provide callers with CPR instructions over the phone; and the increased placement and availability of automated external defibrillators (AEDs).

“We’ve made it part of our culture, and we’ve seen positive results,” said King County Executive Dow Constantine.

To improve on the record-setting achievement, King County has invested in several initiatives such as the People’s Defibrillator, an inexpensive, personalized AED being developed with the University of Washington College of Engineering for wide-scale distribution to the community.

“My challenge to every EMS system is to achieve a 60% survival rate nationwide by the year 2020,” said James Fogerty, director for Seattle and King County EMS. “We know it can be done. Set the goal and work to achieve it.”

We give a thumbs up to King County’s EMS/Medic One program for tirelessly working on ways to improve outcomes from cardiac arrest.

 
 
 
 

Photos Edward T. Dickinson, MD

 

Photo A.J. Heightman

 

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