Cardiac Response Lags in D.C.

Betty Lawson is attended to by Tim Bennet, left, and Adam Corkran. Michael Williams, rear, is chief medical officer for D.C. Fire and Emergency Medical Services. He sometimes makes surprise appearances to evaluate his staff. To raise the District's response time for cardiac arrest cases, he plans to train government workers in CPR. (By Sarah L. Voisin/Post)
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Both drugs have significant street value, and there are concerns about theft, but Williams said the department has a plan to meet security requirements, which include a double-locking system that makes medics accountable for the drugs.

"The current situation we have is not optimal. We have no interventions to break seizures except for supportive care," Williams said. "Many of our paramedics have complained that they would like to use the tools available to other jurisdictions, and I agree with them completely."

EMS experts said the lack of these drugs is unusual. "I am not aware of any other system with advanced life-support ambulances that do not carry morphine and Valium," said Jerry Johnston, president of the National Association of Emergency Medical Technicians.

City leaders have vowed to improve the EMS system for years, and the death of retired New York Times journalist David E. Rosenbaum in January 2006 spurred additional changes. Gross missteps occurred at almost every point in the care of Rosenbaum, who was hit in the head with a lead pipe during an evening stroll but was assessed as drunk by firefighters and medics at the scene.

In the arena of cardiac arrest survival, Seattle is the national leader. Two of every three, or 67 percent, of cardiac arrest patients make it to the emergency room alive, according to data compiled by the Abaris Group, a consulting firm that worked with the city's EMS task force last year.

Arriving in the emergency room with a pulse is important, but experts said the true rate of cardiac arrest survival is how many people are discharged from the hospital. In Seattle, that's 45 percent of cardiac arrest patients, according to Abaris.

The District's discharge rate is unknown because the city doesn't track those figures; neither do surrounding jurisdictions.

Officials in Alexandria said the number of cardiac arrest patients arriving at the hospital with a pulse has risen to almost 50 percent after medics started using a ResQPOD. The device, which is disposable and retails for $100 online, helps increase blood flow and is recommended by national health organizations.

Training people to use defibrillators and making the devices available have had a clear impact on boosting rates, experts said.

A recent effort to put defibrillators in Montgomery fitness centers has had dramatic results.

"We've had eight saves in health clubs in 21 months. That is phenomenal," said Asst. Chief Mike McAdams of the county's fire and rescue department.

"Cities don't achieve higher survival rates by chance or circumstance," said Jocelyn Rogers, a spokeswoman with the mid-Atlantic affiliate of the American Heart Association. "They do so by increasing access to automatic external defibrillators, training more lay rescuers to use them and perform CPR, and ensuring that EMS and hospital protocols give cardiac arrest patients the fastest and best treatment possible."