The information provided below shows how HVA performs in various clinical areas.  It is our intention to add to these measures in the future as the HVA Board Quality Committee reviews and refines relavent practices. 

 

 

 

Above:  For chest pain patients, this is the average time between the paramedic arrival at the patient's side and when the 12-lead ECG is finished.  This is important because if the ECG shows a blockage in the heart, it is important to notify the receiving hospital so that the cardiac reperfusion team can be activated.

 

For CPAP patients, this is the percentage of patients that receive relief when their respiratory rate decreases (improves), oxygen saturation improves, or when the paramedic documents other respiratory relief.  CPAP is important because patients become more comfortable and are less likely to have escalating medical problems.  Improvement in respiratory status also results in reduced use of ventilators in the hospital, which decreases hospital stay.

 

For advanced airway placement, this includes patients who are not breathing, or patients where the breathing is severely compromised.  It includes endotracheal or nasaltracheal intubation or placement of a Combitube.  For some patients and in some settings, tube placement can be difficult.  Note:  When advanced airway placement is not possible, paramedics utilize an orolpharyngeal airway to maintain an airway.

 

 

Above:  Patient survival from sudden death is one method by which some EMS systems measure their effectiveness.  Survival depends on many things, many of which are not under the control of the ambulance service.  About 59% of all sudden death patients present with an asystolic ECG (commonly refered to as a "flat line" rhythm) and another 15% of patients have PEA (pulseless electrical activity) which indicates that the electrical rhythm of the heart exists but the beats are not captured by the heart muscle.  Survival from asystole or PEA (74% of all cases) is possible but unlikely.

 

Ventricular tachycardia (V-Tach) and ventricular fibrillation (V-Fib), is initially displayed in about 24% of sudden death cases and have a higher potential for survival.  Activities which improve the chances of patient survival include:

 

• witnessing the episode occur
• rapid activation of the 9-1-1 system
• application of CPR (cardiopulmonary resuscitation) or the prompting of bystanders to begin performing CPR by the 9-1-1 operator
• early defibrillation of the patient (by public access AED's or first responders)

 

The cardiac arrest data contained in this dashboard report is provided by the Washtenaw-Livingston Medical Control Authority (WLMCA), and the data includes cardiac arrests in both counties.  The WLMCA follows the Utstein template in defining these patients, their underlying heart rhythms, treatments applied, and survival definitions.  Reporting of this data occurs usually about 12 months after the calendar year, due to the steps necessary to examine EMS and hospital records.