Gran Jurado del Condado de Santa Cruz
1999-2000
Vista rápida
Detalles completos →
Hallazgos & Recomendaciones
28 hallazgos
F1:
The 911 system for most of Santa Cruz County is administered through the Santa Cruz Consolidated Emergency Communications Center, commonly called Net Com. Additional public safety answering points for the 911 system are in Scotts Valley and at the University of California’s Santa Cruz campus.
F2:
Net Com is an up-to-date, modern facility. Dispatchers have access to computer- aided dispatch systems that allow them to rapidly send police, fire, and medical assistance when needed. For medical calls involving a person not breathing, such as sudden cardiac arrest, Net Com was able to dispatch Emergency Medical Service units within 60 seconds 92 percent of the time in 2006.
F3:
The Emergency Medical Services Integration Authority (EMSIA) — consisting of the Aptos/La Selva Fire District, Central Fire District, Scotts Valley Fire District, City of Watsonville Fire Department, and City of Santa Cruz Fire Department — provides first responder Advanced Life Support (ALS) medical services to the urban areas of the county.
F4:
The remainder of the county receives first responder Basic Life Support medical services from a variety of smaller fire departments and the California Department of Forestry.
F5:
American Medical Response (AMR), a private ambulance service, coordinates with the EMSIA agencies for first responder ALS service and through its contract with the County of Santa Cruz is the sole provider of medical transport in the county.
F6:
EMSIA fire agencies are able to provide a paramedic to a medical emergency within eight minutes of dispatch 90 percent of the time in urban areas.
F7:
AMR is able to provide an ambulance to a medical emergency within 12 minutes of dispatch 90 percent of the time.
F8:
A fire department paramedic is the first one to arrive at a medical emergency about 60 percent of the time.
F9:
The expectations of service are carefully listed in the emergency services’ contracts issued by the county to American Medical Response. AMR coordinates its services with the EMSIA to ensure the best possible service to the citizens of Santa Cruz County. AED Distribution and Training
F10:
Manual defibrillators, such as those carried by fire department and AMR paramedics, are expensive and complex and require significant training and experience to be effective. Conversely, automated external defibrillators (AEDs) are reasonably priced and simple to operate by anyone with a minimum of training. - 4 Surviving Sudden Cardiac Arrest
F11:
Santa Cruz County does not have a comprehensive policy regarding the distribution and installation of AEDs in public locations.
F12:
AEDs are carried in police patrol cars in Scotts Valley. No other law enforcement agencies in the county require AEDs in their vehicles.
F13:
The locations of AEDs in the county are not available to Net Com dispatchers.
F14:
When AEDs are deployed in public buildings, they are often not visible and therefore not accessible when needed.
F15:
CPR classes, including training in the use of AEDs, are available through a variety of sources in the county. Need for AEDs
F16:
While immediate CPR can buy valuable time for a sudden cardiac arrest victim, defibrillation is the only treatment that can save the victim’s life by restoring the heart’s spontaneous rhythm.
F17:
People of any age may suffer sudden cardiac arrest and die suddenly.
F18:
Sudden cardiac arrest is different from a heart attack although coronary artery disease may reduce heart circulation and eventually result in SCA.
F19:
Often the first sign that a person is vulnerable to ventricular fibrillation is an attack that results in sudden cardiac arrest and death.
F20:
In Santa Cruz County, approximately 250 people per year are victims of out-of- hospital sudden cardiac arrest. From October 2004 through September 2006, more than half of these victims (51 percent) were not candidates for resuscitation, mostly because too much time had elapsed before emergency medical services could be activated.6
F21:
Some common causes for sudden cardiac arrest include asphyxia due to drowning or other oxygen deprivation, congenital heart conditions, sudden blows to the chest, electrocution, and coronary artery disease.
F22:
The worst combination for cardiac arrest survival is if patients collapse without witnesses, and when discovered, receive no bystander CPR while emergency services personnel are en route. In a two-year period in Santa Cruz County, only two of 215 patients in this situation had their hearts begin to beat again, and neither survived. When sudden cardiac arrest was witnessed and immediate CPR was administered, nearly a quarter of the victims regained pulses and 10 percent survived. The survival rate jumped to 19 percent when EMS professionals witnessed cardiac arrest and could begin treatment immediately. There were 16 EMS-witnessed cases in the two-year period, and three of those were found to be 6 SCA Audit, p. 6. Surviving Sudden Cardiac Arrest - 5 in ventricular fibrillation (as opposed to those with no electrical activity or pulse). All three were successfully resuscitated with defibrillation only.7
F23:
Some experts believe that a connection may exist between the use of ‘Tasers’ by law enforcement and sudden cardiac arrest in some individuals.
F24:
To improve the survival rate of victims of out-of-hospital cardiac arrest in Santa Cruz County, the Emergency Medical Services Integration Authority recommends “promulgating citizen CPR programs, Public Access Defibrillator (PAD) programs, and continued rapid EMS response using all the latest AHA (American Heart Association) recommendations for CPR, defibrillation, and advanced life support care.”8 Laws related to AEDs
F25:
Effective July 1, 2007, the State of California will require all health clubs to be equipped with AEDs on site and establish a program of training, maintenance, and record keeping.
F26:
Good Samaritan laws protect most citizens from liability if they take action in a medical emergency, which includes using an AED. Conversely, lawsuits have been filed against organizations such as amusement parks and airline companies for not having AEDs readily available.
F27:
AEDs are now required at FAA governed airports and on all commercial airliners.
F28:
The Federal Cardiac Survival Act of 2000 (Public Law 106-505) directed the Health and Human Services Department to establish guidelines for evaluating and installing AEDs in federal buildings. Conclusions:
Recomendaciones adicionales
9
No vinculadas a hallazgos específicos.
R1:
The Santa Cruz County Health Services Agency should establish a public education program to enhance the community’s knowledge and awareness of CPR and the use of AEDs as a life-saving measure.
R2:
The locations of AEDs in the county should be entered in Net Com’s Computer- Assisted Dispatch system.
R3:
Santa Cruz County should require AEDs in county buildings with more than 100 employees or daily visitors and in county detention facilities, including Juvenile Hall.
R4:
Santa Cruz County should encourage the use of AEDs in the following public locales and private settings: • Public schools • Public swimming pools • Public libraries • Large concerts and other public events • Public golf courses • Churches with a capacity of 100 or more • Private schools • Private recreation clubs Surviving Sudden Cardiac Arrest - 7 • Medium to large hotels and motels • Shopping centers • Medical and dental offices • Private golf courses • Senior citizen centers and care facilities
R5:
The county and each city should equip law enforcement vehicles with AEDs.
R6:
The county should establish a mechanism to ensure that once AEDs are deployed by public agencies, those responsible meet the requirements needed to shield the county from liability by providing training, maintenance, record keeping and medical oversight.
R7:
The county should establish a reporting and inspection mechanism to ensure that AEDs deployed in the community are identified by Net Com and thereby viable in case of an emergency.
R8:
The county should develop a strategy for implementing a meaningful public access defibrillator program that meets the criteria of the American Heart Association and American Red Cross recommendations.
R9:
The county should explore funding opportunities to pay for an expanded public access defibrillator program from both public and private sources, possibly enlisting the aid of community service organizations. Commendation Santa Cruz County’s emergency services teams and organizations for providing the most efficient and responsive services possible under current conditions. - 8 Surviving Sudden Cardiac Arrest