By Michael J Jacobs, EMT-P
& Karl A Sporer, MD, FACEP, FACP
Every year, more than 400,000 people suf- fer non-traumatic out-of-hospital cardiac arrest (OHCA) in the United States.
represents the third leading cause of death in industrial nations and accounts for eight times as many
deaths as caused by car crashes.
Previous decades have seen minimal improvement in survival outcomes,
1 but recently, many
systems are improving survival rates among OHCA
patients by using a systems-based approach.
Many successful EMS systems have adopted
a number of changes to improve outcomes.
Alameda County (ALCO) EMS has made a num-
ber of sequential changes over the last decade to
improve OHCA care. This article addresses those
changes and the resulting improvement in cardiac
The endorsed system of care for OHCA by ALCO
EMS has been modeled after that of the decade-old
and nationally recognized Take Heart America.
All of the changes and system design are based
upon recommended evidence-driven treatment
strategies, techniques and devices that are consistent with the 2005, 2010 and 2015 American
Heart Association (AHA) Guidelines.
These have included measures to improve the
rate of bystander CPR through CPR- 7, a community outreach education program using seventh
graders and those they train; use of dispatch-assisted CPR; and the implementation of Pulse-
Point, a method of crowdsourcing citizen CPR.
We’ve improved prehospital cardiac arrest
Alameda County (Calif.) EMS coordinates with clinical
stakeholders to improve cardiac arrest survival