New Protocol at Medic is Increasing Survival Rates among Cardiac Arrest Patients

For Immediate Release
Contact: Kristin Young
Public Relations Manager
Mecklenburg EMS Agency
704.943.6165 (office)
704.619.3035 (cell)

New Protocol at Medic is Increasing Survival Rates among Cardiac Arrest Patients

Agency’s Success with Sudden Cardiac Arrest Victims are Among the Best in the Nation

March 2011 – Charlotte, NC: Mecklenburg EMS Agency (Medic) is reporting significantly improved results in treating sudden cardiac arrest victims thanks to a new protocol that the Agency implemented in August of 2009 called the Focused Cardiac Arrest Protocol. In the first twelve months following implementation of the new protocol, Medic’s success with sudden cardiac arrest victims in the Prehospital setting has improved by 11%. Such success in the Prehospital setting is critical as it provides patients with the foundation required to have any chance for survival.

Medic has historically experienced strong success with sudden cardiac arrest victims; in fact, the Agency was already publishing results that were among the best in the nation. Recognizing that there were still ways to improve the process of managing sudden cardiac arrest cases by better understanding the various components that contribute to better outcomes, the Agency was able to choreograph a more regimented protocol that could be replicated and taught to Medic Paramedic Teams and area First Responders in a very consistent format.

Medic officials spent much of the summer of 2009 deconstructing and rebuilding each of the key roles related to managing a sudden cardiac arrest case in the Prehospital setting. Each role was analyzed, documented and assigned to a member of the typical emergency response team that responds to such emergencies. This includes Medic Paramedics, EMTs and First Responder personnel from area fire departments. The intent of this strategy was to ensure that each member of the response team was trained to function as part of a team by being the expert on one specific aspect of the overall care required. The hypothesis was that each emergency responder would then be able to provide the most consistent and reliable care possible.

“The best analogy I can think of is to imagine the interoperability of a NASCAR Pit Crew,” said Dr. Doug Swanson, Medical Director for Mecklenburg EMS Agency. “Every member of the Pit Crew has a specialty they practice over and over; you could theoretically assemble team members from various Pit Crews, put them all together, and they would still function very well as a team because each knows their specific role and what is expected of their other team members. That is the same level of consistency we have built among emergency responders in Mecklenburg County. Any Medic crew can arrive on scene with any First Responder Team and everyone instantly knows their role in treating a sudden cardiac arrest victim. That level of cohesiveness and consistency is unheard of in an EMS System of this size, and its producing results that matter.”

Medic initially launched its Focused Cardiac Arrest Protocol in Charlotte’s city limits as it is where the largest number of sudden cardiac arrests occur in Mecklenburg County. Medic spent more than a month training First Responders with the Charlotte Fire Department so that each team member was not only well versed at their specific role but so they were also aware of the order and methodology with which each role was to be performed. Once the training process, roll out and implementation proved effective, Medic officials proceeded to train emergency responders at the other 18 fire departments across Mecklenburg County.
Since implementing the focused cardiac arrest protocol, Medic’s success at attaining Return of Spontaneous Circulation* (ROSC) with out of hospital cardiac arrest victims presenting either ventricular fibrillation** (VF) or ventricular tachycardia*** (VT) has increased by more than 11%. Survival to hospital discharge rates for VF/VT patients treated by Medic also remained high throughout the first year of the Protocol’s implementation, at over 32%; this figure places Medic’s performance among the best published results in the nation.

Comparatively, national rates of survival to hospital discharge for patients experiencing a VF/VT arrest range from 7.7% - 39.9% according to a 2008 study published by the Journal of the American Medical Association titled Regional Variation in Out-of-Hospital Cardiac Arrest Incidence and Outcome.

Medic is continuing to document and analyze the results associated with the Agency’s Focused Cardiac Arrest Protocol with an eye on continued process improvement. The Agency’s strong relationships with Carolinas Healthcare, Presbyterian/Novant and area First Responders only enhance the Agency’s ability to successfully improve patient care through such groundbreaking endeavors.

Medic has served as Mecklenburg County’s EMS Agency since 1978. With more than 425 employees and a diverse fleet consisting of various ambulances, mass casualty vehicles and emergency response assets, Medic will respond to more than 100,000 calls for assistance received by the organization’s 911 emergency response dispatch center in 2011 alone. For more information please log on to

Frequency of Survival and Return of Spontaneous Circulation in Patients Experiencing Cardiac Arrest


*Return of spontaneous circulation (ROSC) is resumption of sustained perfusing cardiac activity associated with significant respiratory effort after cardiac arrest Signs of ROSC include breathing, coughing, or movement and a palpable pulse or a measurable blood pressure.
** Ventricular fibrillation is a cause of cardiac arrest and sudden cardiac death. The ventricular muscle twitches randomly, rather than contracting in a coordinated fashion (from the apex of the heart to the outflow of the ventricles), and so the ventricles fail to pump blood into the arteries and into systemic circulation.
*** Ventricular tachycardia is a tachycardia, or fast heart rhythm, that originates in one of the ventricles of the heart. This is a potentially life-threatening arrhythmia because it may lead to ventricular fibrillation, asystole, and sudden death.

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