Survival in Seattle: the Cardiac Arrest Survival Summit

Seattle, Washington is primarily known for three things: being the hometown of Starbucks coffee; being the birthplace of grunge; and having an impressive rate of survival from out-of-hospital cardiac arrest (OHCA). It was therefore appropriate that the Cardiac Arrest Survival Summit took place in downtown Seattle at the Hyatt Regency Hotel between 9–13^th December 2019. Delegates representing 21 countries from around the world converged on the Pacific Northwest to hear from internationally recognised clinicians, leaders and patients who sought to inform and motivate delegates to improve survival from sudden cardiac arrest in their own community. This conference review seeks to disseminate key messages from the Cardiac Arrest Survival Summit to a wider audience and is supplemented by the author's own experience of meeting the leadership team at King County Medic One and undertaking clinical observation shifts with an ambulance crew in South Seattle.

Survival from OHCA is measured using internationally agreed criteria, referred to as the Utstein Reference Standard (Cummins et al, 1991), and such a standardised reporting system allows comparisons between systems. In 2018–19, the London Ambulance Service reported survival to hospital discharge rates for patients with an initial presenting rhythm of ventricular fibrillation or ventricular tachycardia (VF/VT) of 36.6% (London Ambulance Service, 2019) and while this is above the national average for England, it is below the 56% figure reported by King County Seattle (Seattle and King County Emergency Medical Services (EMS), 2019). While this article seeks, in part, to shed some light on how Seattle has achieved such impressive rates of survival from OHCA, it is also worth considering the contextual background.