The San Ramon Valley, a residential and business community located east of San Francisco, has a reputation as being one of the safest places in the United States to experience a cardiac emergency. According to the Center for Disease Control and Prevention (CDC), about 610,000 people die of heart disease in the United States every year, accounting for 1 in every 4 deaths. Every year about 735,000 Americans have a heart attack. Of these, 525,000 are a first heart attack and 210,000 happen to people who have already had a heart attack.1 Recent data has shown that patients who experience sudden cardiac arrest are twice as likely to survive if that episode occurs in the San Ramon Valley.
Nationally, if someone experienced a sudden cardiac arrest outside a hospital setting in 2014, their chances of surviving were 10.3 percent, depending on factors such as whether a bystander witnessed the arrest and was able to call 911 quickly, if the patient’s heart was in a shockable rhythm (responsive to defibrillation), or if a bystander performed some type of intervention (like CPR or defibrillation with an Automated External Defibrillator – AED).2 In 2014 a cardiac patient’s chances of survival were higher in the San Ramon Valley than the National average, at 13.2 percent, but jumped to 71.4 percent for patients whose cardiac arrest was witnessed and who were in a shockable rhythm. A patient’s chances of survival further jumped to 80 percent for a witnessed, shockable arrest and where a bystander performed some type of intervention like CPR or defibrillation. Compared to the National average of 32.8 percent for
1 Heart Disease Facts; Centers for Disease Control and Prevention website, http://www.cdc.gov/HeartDisease/facts.htm
2 Cardiac Arrest Registry to Enhance Survival (CARES); 2014 Presumed Cardiac National Utstein Report website, https://mycares.net witnessed/shockable and 36.3 percent for witnessed/shockable/intervention(CPR)-performed, residents of the San Ramon Valley have about a 120 percent greater chance of surviving a witnessed, shockable heart attack than their friends and family in most of the rest of the country.
These astounding save rates are part of a team effort, from citizens who get involved by calling 911 early, performing high quality CPR and using a defibrillator if needed, to the high performing Emergency Department (ED) staff of the three primary local hospitals3. The vital link between the citizen callers and the ED staff is the San Ramon Valley Fire Protection District (District). The District receives the 911 calls at their nationally accredited Emergency Medical Dispatch Center of Excellence4 and dispatchers provide emergency medical instructions to the callers, while at the same time dispatching to each emergency an Advanced Life Support (ALS) fire engine and an ALS ambulance. Both the fire engine and the ambulance are staffed with first responders who are highly experienced ALS Firefighter/Paramedics and Basic Life Support Firefighter/Emergency Medical Technicians. The dedicated District dispatchers and first responder crews effectively communicate and efficiently work together to provide seamless, high quality patient care from call receipt all the way to the hospital ED, regardless of the severity of the patient’s illness.
“We are very proud of our cardiac arrest survival statistics,” said District Fire Chief Paige Meyer. “We attribute our success to many factors, including our 911 Communication Center that utilizes Emergency Medical Dispatching (EMD), our rigorous paramedic training program, state of the art equipment on all our fire engines and ambulances, the development of our PulsePoint mobile phone app and our community outreach program that teaches hands-only CPR to over 2000 residents each year.”
District Deputy Chief of EMS/Logistics Derek Krause echoed the Chief’s statement, “Our statistics have always been high, and our EMS (Emergency Medical Service) is second to none. The challenge for us this year is to fully understand how we achieved such a phenomenal save rate in 2014, be able to consistently repeat 2014’s success, and to share what we learn with as many EMS agencies as are interested in the results of our internal evaluation. And, quite frankly, just because we have an 80 percent save rate doesn’t mean we don’t owe it to our citizens to try to close that last 20 percent”, Chief Krause said. “We have a tradition of sharing our wins with the rest of the country, like the citizen responder CPR/AED mobile app PulsePoint5 that was developed here at San Ramon Valley Fire; if there is anything we can do to help save lives here or elsewhere, we’re going to try it.”
3 Local hospitals are San Ramon Regional Medical Center, San Ramon; Kaiser Hospital, Walnut Creek; and John Muir Medical Center, Walnut Creek.
4 The District’s Communications Center provides pre-arrival instruction to responding emergency personnel utilizing the Medical Priority Dispatch System which is integrated into the District’s Computer Aided Dispatch (CAD) system. Emergency instructions are given by highly skilled dispatchers trained in assisting a caller in life saving techniques such as CPR. Dispatchers will continue to talk to the caller through the emergency until the emergency crew arrives, and will assure the caller that help is on the way. In 1996, the District’s communications center was accredited by the National Academy of Emergency Medical Dispatch (NAEMD) as an Accredited Center of Excellence – only the seventh center at that time to receive this prestigious award worldwide. In 2000, 2004, 2008, 2012 and in 2014 the communication center was reaccredited by NAEMD.
5 PulsePoint, conceived and piloted by the San Ramon Valley Fire Protection District, empowers individuals within covered communities the ability to provide life-saving assistance to victims of Sudden Cardiac Arrest. Application users who have indicated they are trained in cardiopulmonary resuscitation (CPR) are notified if someone nearby is having a cardiac emergency and may require CPR. If the cardiac emergency is in a public place, the application uses sophisticated location-based services to alert citizens in the vicinity of the need for CPR. The application also directs
The District is also a robust partner in the HeartSafe Community Program6 which better prepares the public to initiate the first links in the chain of survival before the firefighters arrive, through CPR training for adults and school children, and AED placements throughout the District. “As a sudden cardiac arrest survivor and advocate for bystander CPR and AED use, I know the importance of rapid quality care,” said San Ramon Valley resident Joe Farrell. “I am proud to live in a community that takes such pride in their level of patient care and I rest easy at night knowing I’m safer simply because I live here.”
The delivery of high quality, effective patient care in the District is facilitated by an EMS Coordinator and an EMS Captain who report to the EMS Battalion Chief, and are in turn supported by a dedicated Deputy Chief of EMS/Logistics. The District’s EMS Division works closely with area doctors who specialize in pre- hospital EMS, and is supported by the Contra Costa County Emergency Medical Service staff in progressive EMS techniques and equipment as the boundaries are pushed to provide better, more efficient, more effective emergency medical services. The District operates five fully equipped ALS ambulances around the clock and maintains an additional four ambulances in reserve with crews available, if needed. District ALS ambulances are equipped with state of the art medical equipment and staffed with Firefighter/Paramedics. All District fire engines and trucks are also staffed with at least one Firefighter/Paramedic.
The San Ramon Valley Fire Protection District is an internationally-accredited special district that provides all-risk fire, rescue and emergency medical services to the communities of Alamo, Blackhawk, the Town of Danville, Diablo, the City of San Ramon, the southern area of Morgan Territory and the Tassajara Valley, in Northern California (Contra Costa County). The District’s service area encompasses approximately 155 square miles and serves a population of 170,000.
For more information, visit our website at www.firedepartment.org .
citizen rescuers to the exact location of the closest public access Automated External Defibrillator (AED). More information about PulsePoint can be found at www.pulsepoint.org.
6 The HeartSafe Community Committee is made up of representatives from the San Ramon Valley Fire Protection District, the City of San Ramon, the Town of Danville, the San Ramon Valley Unified School District, Contra Costa County Emergency Medical Services and many committed community members under the charge of the San Ramon Valley Citizen Core Council. The mission of the group is to encourage residents to learn hands-only CPR, promote the placement of public access AEDs in local businesses and community buildings, and facilitate the CPR in the Schools program. Since the Committee achieved HeartSafe status in January of 2011, they have trained over 6500 community members in hands-only CPR and the proper use of an AED. Additionally, during this time the District has seen a sharp increase in the occurrence of bystander CPR. , In 2010 bystander CPR was administered 35 percent of the time and in 2012 that number had risen to over 50 percent.