Don’t get a heart attack in DC

Today USA Today begins what looks like a very important series on emergency medical services. The paper’s own study finds that Washington DC has the worst survivability rate, and Seattle has the best. EMS is a good example of mission creep — how government takes up new causes and neglects important ones, like emergency care. One particularly enraging aspect about EMS is that we don’t know enough about it as we should. Agencies generally resist studies that compare one city’s service to another’s, and this study apparently ran into much of the same: Most cities refused to answer USA TODAY’s question comparing response times on fires and emergency medical calls, but a few cities, including San Francisco, Mesa, Ariz., and Wichita, said their firefighters also are slower to respond to medical emergencies than to fires. What accounts for Seattle’s success? One of the biggest factors contributing to Seattle’s success is its culture. There, the medicine delivered in the streets comes from firefighters and fire department paramedics who have very different jobs but work on the same team. Each has a well-defined role to play in the patient’s care, with firefighters reaching victims first and performing basic care until paramedics arrive to administer advanced cardiac life support.