king county paramedic

STUDY OBJECTIVE: To determine the outcome, location, preexisting conditions, and resuscitation wishes of prehospital cardiac arrest patients. DESIGN: Retrospective review of paramedic and emergency medical technician run reports. SETTING: Urban area with a two-tiered emergency medical services response system covering an area of 2,128 square miles and serving a population of 1,413,900 (in 1988). PARTICIPANTS: All prehospital cardiac arrest patients to which the King County, Washington, Emergency Medical Services (KCEMS) system responded to during a 12-month period...

STUDY OBJECTIVES: To determine whether criteria based dispatch (CBD) improved the efficiency of the emergency medical services system. DESIGN: A before and after design was used to measure effects of CBD. Data were reviewed from medical reports from January 1986 through June 1992. SETTING: King County, Washington, excluding the city of Seattle. PARTICIPANTS: Residents who called 911 to report a medical emergency. INTERVENTIONS: Emergency medical dispatching (EMD), basic life support (BLS), and advanced life support (ALS)...

STUDY OBJECTIVE: To determine the reasons patients with suspected acute myocardial infarction (AMI) delay seeking medical care or do not call 911. DESIGN: Telephone interview of patients hospitalized with suspected AMI. SETTING: Nine hospitals in King County, Washington. PARTICIPANTS: Patients admitted to a CCU or ICU between October 1, 1986, and December 31, 1987, with suspected AMI occurring out-of-hospital. Spouses of patients who met criteria but died during the hospitalization also participated...

OBJECTIVE: To assess whether the dietary intake of long-chain n-3 polyunsaturated fatty acids from seafood, assessed both directly and indirectly through a biomarker, is associated with a reduced risk of primary cardiac arrest. DESIGN: Population-based case-control study. SETTING: Seattle and suburban King County, Washington. PARTICIPANTS: A total of 334 case patients with primary cardiac arrest, aged 25 to 74 years, attended by paramedics during 1988 to 1994 and 493 population-based control cases and controls, matched for age and sex, randomly identified from the community...

The marginal costs per averted death of a suburban paramedic program are estimated to be approximately $42,000, when program costs are attributed entirely to cardiac arrest cases due to underlying heart disease, and indirect costs attributable to episode-related hospitalization are included, It is suggested that at $42,000 per cardiac arrest death averted the program is cost-beneficial by two criteria. First, it compares favorably with an estimate obtained from the literature of the value to the average individual of saving the life of a myocardial infarction patient...

A surveillance system identified all out-of-hospital cardiac patients under the age of 18 who received emergency care in suburban King County, Washington. The etiology, cardiac rhythm, and outcome were identified for each case. During a 6 1/2-year period, 119 cardiac arrests occurred (annual incidence, 12.7/100,000 among individuals less than 18). Sudden infant death was the most common etiology (32%), and drowning was the second most common (22%). The most common rhythm was asystole, accounting for 66% of all rhythms...

Many recent efforts to improve emergency medical services (EMS) and increase survival rates are simply efforts to get defibrillation to patients as rapidly as possible. In the 1960s physicians traveled in mobile coronary care units to bring the defibrillator to cardiac arrest patients. Later, paramedics, rather than physicians, were used. During the late 1970s the concept of early out-of-hospital defibrillation expanded as emergency medical technicians (EMTs) learned to defibrillate. Researchers in several settings confirmed the effectiveness of early defibrillation by EMTs...

The factors associated with submersion events among less than 20-year-old persons that occurred in King County from 1974 to 1983 were studied to focus prevention efforts. Near-drowning (n = 103) and drowning (n = 96) victims were identified from medical examiners' reports, paramedics' reports, and hospital discharge registers. Annual incidence was 5.5; the mortality rate was 2.6 per 100,000 children. Although preschool-aged children had the largest incidence (12.8), followed by older adolescents (4.9), adolescents had the largest case fatality rate, 77%...

There have been no studies of the nature of defibrillatory shocks or risks to persons, providing them other than one individual case report and a number of incidental accounts. In this study, the severity and nature of injuries to prehospital emergency personnel in King County, Washington are reported. In addition, the types of injuries occurring to defibrillator operators throughout the United States, as voluntarily reported to the Food and Drug Administration (FDA), are described. In King County, prehospital emergency personnel reported eight accidental shocks...

Predictors of outcome in pediatric submersion victims treated by Seattle and King County's prehospital emergency services were studied. Victims less than 20 years old were identified from hospital admissions and paramedic and medical examiners' reports. The proportion of fatal or severe outcomes in patients were compared with various risk factors. Of 135 patients, 45 died and 5 had severe neurologic impairment. A subset of 38 victims found in cardiopulmonary arrest had a 32% survival rate, with 67% of survivors unimpaired or only mildly impaired...

Although most studies have concentrated on fatal residential fire injuries, which are a leading cause of fatal injuries in the United States, few investigators have examined in detail nonfatal injuries as a consequence of residential fires. This population-based study used the Washington State Fire Incident Reporting System to assess the incidence and descriptive epidemiology of fatal and nonfatal burns or respiratory tract damage resulting from unintentional residential fires. For the 2-year period 1984-85 in King County, WA, the mortality rate due to injury in a residential fire was 0...

As part of an ongoing study of determinants of out-of-hospital cardiac arrest, the Seattle-King County Department of Health conducted an anonymous human immunodeficiency virus (HIV) serosurvey of these patients in Seattle from January 1989 through December 1990. The serum specimens were obtained from patients for whom cardiopulmonary resuscitation (CPR) was initiated by bystanders or emergency medical technicians (EMTs) and for whom endotracheal intubation and intravenous therapy were administered by paramedics...

STUDY OBJECTIVE: To discover the frequency of agonal respirations in cardiac arrest calls, the ways callers describe them, and discharge rates associated with agonal respirations. DESIGN: We reviewed taped recordings of calls reporting cardiac arrests and emergency medical technician and paramedic incident reports for 1991. Arrests after arrival of emergency medical services were excluded. SETTING: King County, Washington, excluding the city of Seattle...

Two evaluation methods, one statistical and one comparative, were developed to assess the effectiveness of paramedic programs in King County, Washington. The outcome of hospital admission following prehospital cardiac arrest was used as a measure of effectiveness. In the statistical method, actual outcomes were compared with predicted outcomes. Predictive variables for admission were time from collapse to initiation of cardiopulmonary resuscitation and time from collapse to definitive care. Given knowledge of the predictive variables, the statistical evaluation enabled us to determine the probability of the outcome following cardiac arrest...

Out-of-hospital cardiac arrest was studied in suburban King County, Washington in an attempt to determine the impact of paramedic services on community cardiac mortality. A portion of the study area received paramedic services and the remainder received basic emergency medical technician (EMT) services. A surveillance system identified all prehospital cardiac arrest incidents. The etiology and outcome were determined. Deaths due to primary heart disease (ICDA) codes 410-414) were compared to community cardiac mortality figures for the same period of time and in the paramedic and EMT areas...