Multnomah County cardiac arrest survival rates decline

Multnomah County cardiac arrest survival rates decline
In a 2018 meeting, Tri-County Health Officer Dr. Paul Lewis — also the director of the EMS program — was ecstatic about the survival rate for cardiac arrest in the county.

“Multnomah County cardiac arrest survival in 2016 was twice as high as the national average — 16.9% vs 8.4%. Twice!” he exclaimed.

The Multnomah County EMS Office has used this statistic to measure the performance of the overall EMS system.

Times have changed.

Not only has the latest cardiac arrest survival rate dropped 3% from the previous year, it’s now down nearly one-third from the highest rate measured — 20.8% — in 2016.

The current Multnomah County EMS Medical Director, Dr. Jonathan Jui, said there are reasons for the decline that is directly linked to the number of overdose deaths.

“The devastating effect of fentanyl on our community is an external factor EMS cannot control,” Dr. Jui said. “However, our data indicates that the overall survival has stayed the same or actually increased by presenting rhythm. Regarding quality of care, we are actually at 2022 levels or higher when you look at the presenting rhythms data and survival outcomes.”

The latest Utstein Survival Reports shows Multnomah County’s 2023 overall cardiac arrest survival rate of 12.7% lags behind Clackamas County (15.5%) and Washington County’s 23%. But all are well above the national average of 9.7%

“Research shows that if cardiac arrest is witnessed, if there is bystander CPR and use of an automatic defibrillator, and if there is rapid first response, patients are more likely to survive a cardiac arrest in the nation and in Multnomah County,” said Dr. Stephen Dean, a former paramedic and EMS director.

Ambulance response times in Multnomah County are also falling. In some months, ambulances meet the required arrival time only about half the time — well off the 90% standard.

Patients haven’t received regulated response times county-wide since February 2022.

“Response times and cardiac arrest survival rates are related,” Dean said. “Longer ambulance arrival times correlate with reduced chances of patients survival.”