In Clark County, the Emergency Medical Services (EMS) system is a seamless network of multiple agencies dedicated to one mission: saving lives.
When a resident calls 911, an impressive team of as many as 15 individuals can arrive on the scene within six minutes to provide critical assistance.
This swift response is the result of meticulous coordination among various components of the Clark County EMS system, which includes 911 dispatchers, first responders, and ambulance services.
Marlow Macht, the Medical Director of Clark County EMS, emphasizes that the backbone of this system is a culture of cooperation and a commitment to continuous improvement.
“It’s both about getting the right resources to the scene but also triaging appropriately, so we’re not diverting resources to calls where they are less likely to be helpful, and that’s part of making the system more efficient,” Macht stated.
Last year, their combined efforts resulted in saving the lives of 55 patients who experienced cardiac arrest.
The efficiency of the EMS system begins with the initial 911 call.
The Clark Regional Emergency Services Agency (CRESA) plays a pivotal role in providing emergency management and 911 dispatch services to residents across a service area comprised of seven cities, including Vancouver, Battle Ground, and Washougal, along with unincorporated areas of Clark County.
According to CRESA Quality Assurance and Accreditation Specialist Dawn Floyd, the knowledge and quick problem-solving skills of dispatchers are vital for the successful operation of the 911 system.
Moreover, the instruction provided by dispatchers over the phone for CPR significantly impacts survival rates.
Floyd highlighted the importance of how CPR is administered during these calls, referring to the method as “high-performance CPR.” When executed effectively, this approach creates the best potential outcomes for patients in distress.
CRESA employs the Emergency Medical Dispatch system, which enables rapid dispatching of emergency services and swift CPR instructions, often within mere seconds.
Floyd elaborated, “We give them instructions to pump the chest hard and fast, at least twice per second and 2 inches deep, after we’ve already instructed them on positioning the patient.”
The dispatchers guide callers on how to maneuver a patient from a bed or chair onto the floor for CPR, ensuring that help is on the way as quickly as possible.
If necessary, dispatchers also provide instructions on rolling a patient onto their back to make CPR feasible.
In cases where a caller cannot move the patient, dispatchers teach them about “back CPR,” which entails compressions directly on the back of the patient.
To ensure compressions are delivered at the correct rate and depth, CRESA utilizes a metronome diagnostic tool during calls.
According to Dustin Waliezer, EMS training captain for Clark County Fire District 3, having a dispatch center with trained call-takers providing CPR instructions is crucial in the fight against time.
Waliezer explained that brain cells begin to die after just four minutes without oxygen, with survival rates dropping by approximately 10 percent for each additional minute that passes without intervention.
“If we can have someone who starts getting coached by the dispatch center to do CPR, you’re extending that window where you’re stopping cell death until we can get there,” he noted.
CRESA’s commitment to excellence is reflected in their recent achievement of being re-accredited as a Center of Excellence by the International Academies of Emergency Dispatch for the eighth time since 1994.
Only 11 other dispatch centers worldwide have matched this level of re-accreditation, indicating a high standard of service and expertise.
Waliezer drew a comparison between first responders and a Formula One pit crew, noting that each member has specific roles that contribute to a more effective response.
He said, “When we roll onto a scene, we all know exactly what our roles are, and that really helps us stand out. If tasks are assigned at random, it can create delays, and time is of the essence in dire situations.”
Macht also underscored the importance of law enforcement in this coordinated response framework.
Officers are equipped with automated external defibrillators (AEDs) in their vehicles and receive training to use them effectively.
Coordination extends beyond first responders and law enforcement and involves close collaboration with local hospitals as well.
The Clark County EMS utilizes Pulsara, a technological tool that alerts hospital staff with patient information ahead of arrival.
Waliezer noted, “The second we roll across the ambulance bay doors, they already have their system spun up. It’s not a cold start.”
The combined efforts of the Clark County EMS system, along with local hospitals, played an essential role in the successful rescue of 55 patients whose hearts had stopped in the last year.
As reflected in a 2024 clinical performance report, these collaborative efforts are a testament to the effectiveness of the Clark County EMS system.
image source from：columbian
