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Sudden Cardiac Arrest

Sudden cardiac arrest – the leading cause of death in the United States!

Contra Costa Emergency Medical Services (EMS) believes that a community can improve survival from sudden cardiac arrest (SCA) when a comprehensive, community-wide, systems-based approach to the treatment of cardiac arrest is in place.

The cardiac arrest system of care is described on this webpage.

For questions about the materials on this website please contact our office at 925-646-4690.

Our Goals
Key Principles
Public Education
Receiving Centers

  • Our Goals


    A comprehensive countywide cardiac arrest system of care designed to increase:
    Recognition of sudden cardiac arrest,
    Bystander CPR rates,
    AED availability, readiness and utilization;

    To provide:
    Dispatch assisted CPR – decreasing the time to first compression,
    Quality CPR and resuscitative care, and
    Integrated post-cardiac arrest care
    Resulting in increase in survival!


    The Contra Costa Cardiac Arrest System will consist of a collaborative network of citizens (HeartSafe Communities), 9-1-1 prehospital providers, and hospital personnel who are able to identify victims of sudden cardiac arrest and rapidly care for them preventing sudden cardiac arrest from becoming sudden cardiac death.

  • Key Principles & Definitions

    Key Principles

    Rapid recognition and treatment of a victim of SCA is a key component to survival. Knowing the signs of sudden cardiac arrest -

    If someone collapses and is:

    • Not responding
    • Not breathing or only gasping

    Calling 9-1-1 – Acting in Time – beginning CPR and using an AED as soon as one arrives doubles the victims chance of survival.


    Sudden cardiac arrest: (Also known as cardiac arrest) is the abrupt loss of heart function in a person who may or may not have diagnosed heart disease. Sudden cardiac arrest occurs when the heart's electrical system malfunctions and the heart suddenly stops beating, often without warning.

    Sudden cardiac death: Sudden cardiac death can occur when someone in sudden cardiac arrest is not treated promptly.

    Cardiopulmonary Resuscitation (CPR): is an emergency procedure performed in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest. It is indicated in those who are unresponsive with no breathing or abnormal breathing.

    Automated external defibrillator (AED): a lightweight, portable device that delivers an electric shock through the chest to the heart. The shock can stop an irregular rhythm and allow a normal rhythm to resume in a heart in sudden cardiac arrest.

    Cardiac Receiving Center: A hospital designated by Contra Costa County EMS with cardiac capabilities, (cardiac catheterization, laboratory and/or cardiovascular surgery), designed to provide rapid intervention for SCA patients and integrated post-cardiac arrest care.

  • Background

    Heart disease – with its most common manifestation, sudden cardiac arrest – is the leading cause of death among adults in Western countries. Nearly 383,000 out-of-hospital sudden cardiac arrests occur annually, and 88 percent of cardiac arrests occur at home - half of these are sudden and unexpected. Many victims of SCA appear healthy with no known heart disease or other risk factors. Statistically speaking, if called on to administer CPR in an emergency, the life you save is likely to be someone at home: a child, a spouse, a parent or a friend

    Components of a Cardiac Arrest System of Care

    • HeartSafe Community partnerships to promote sudden cardiac arrest recognition and response by our citizens
    • Expeditious EMS dispatch and response
    • Pre-arrival Instructions by EMS dispatch to assist in providing bystander CPR to the victim – decreasing the time to first compression and utilization of nearby AEDs
    • PulsePoint – to bring nearby citizen responders to the victim to provide CPR
    • AED Link – to request trained AED responders to bring their AED to the victim of a SCA decreasing the time to the first shock – the one major factor in survival
    • Public Safety AED programs – providing rapid defibrillation
    • Pre-hospital patient assessment and high quality resuscitation
    • Communication with receiving facilities
    • Cardiac arrest centers to provide rapid, appropriate post arrest care
    • Cardiac arrest system of care post event analysis and review

    Early Action is Key:
    For the best chances of recovery, don't wait, call 9-1-1 immediately! Begin CPR and send someone to get an AED if there is one nearby.
    When an AED is available, turn it on and follow the prompts.

  • Public Education

    Know the Signs of Cardiac Arrest

    If someone collapses and is:

    • Not responding
    • Not breathing or only gasping

    If someone experiences these symptoms

    Call 911 Act In Time

    Begin Hands Only CPR;
    Use an AED as soon as one arrives

  • First Person Stories About Cardiac Arrest

    Joe Farrell's Sudden Cardiac Arrest Survival Story

    Joe & Edie Farrell
    Having experienced a near death experience of Sudden Cardiac Arrest (SCA) has significantly changed my life. The description of my survival is based upon my wife's recollection since I was suddenly stricken with SCA at a professional friend's home in Rocklin, CA 6 years ago. I do not remember anything that happened when I suffered the SCA, nor do I remember the week prior to my SCA.

    We had just arrived at a professional friend's house at 2 pm on August 9, 2008. It was a 1.5 hour drive to their home where we were attending a memorial dinner for our friend's husband who had passed away three weeks prior. I was speaking to a couple of friends and a local track coach who coached my friend's daughter, when I collapsed suddenly, was unconscious and not breathing. The track coach immediately recognized that I was not breathing and thus he started CPR and someone activated the 911 system. The paramedics arrived within 5-6 minutes and I was shocked 4 times to re-establish cardiac rhythm. I was transported to Roseville Sutter Medical Center ER. In the ER I went into SCA again and was shocked four more times. Tests revealed that I did not suffer a heart attack (Myocardial Infarction: MI). I underwent angiography which revealed that my coronary arteries were very clear for a 56 year old man, thus my problem (SCA) was related to an electrical problem or cardiac arrhythmia.

    I was transferred to ICU where I underwent hypothermia. Three days later I came out of a coma and began to recognize my family and a couple of very close friends who were with my wife and two daughters while my body was fighting for survival. I left the hospital 10 days later with an ICD (defibrillator) implanted in my chest and my cognition was normal. Pneumonia contracted in the hospital slowed my recovery, however, two months after my SCA I retuned to work as a physical therapist at my private practice that my wife and I own. In addition, at this point in the post SCA recovery, I was walking 4-5 miles/day, which I continue to do as an important component of my recovery.

    The change in my life also stems from the fact that on August 23, 2007 (year prior to my SCA); I saved a man's life with CPR on a golf course in Incline Village, Nevada. This was a very humbling event since when I came upon the victim he was not breathing, his skin color was blue/black and a man was attempting CPR. I took charge of the scene, a fellow golfer activated the 911 system and I started CPR. It seemed like it took forever for the paramedics to arrive. The paramedics shocked the victim 5x to re-establish his cardiac rhythm. He was then transferred via helicopter with good vital signs to a hospital in Reno, NV. This gentleman survived and to this day, we have become very close friends. SO, saving someone's life with CPR, then surviving a SCA a year later sincerely changes one's perspective on life.

    I remember saying to my golf buddies after saving the man's life that you better hope and pray if you ever go down with a heart issue that you are around someone who knows CPR; because early intervention with CPR will give you about a 50%-80% chance of survival. My good fortune of being in the presence of many colleagues (Physical Therapists) and friends who knew CPR saved my life. These mutually related experiences (e.g. saving a man's life with CPR; then being saved by CPR) made me think that I have to give back to society for my good fortune of surviving a SCA. My wife and I became involved with the San Ramon Valley Fire Districts (SRVFD) Heart Safe Committee (HSC) which has been responsible for putting AED's in every school in our district and in every police car. Edie and I have stimulated our HSC to initiate hypothermia programs in our six local hospitals and currently all paramedics within the SRVFD institute hypothermia in the ambulance for SCA victims. In addition, my wife and I became American Heart Association (AHA) CPR/AED instructors. We have volunteered many hours to teach citizens CPR/AED within our county. Our HSC team as trained over 10,000 citizens in Hands Only CPR and how to use an AED over the past 3.5 years. This year the HSC commenced teaching "hand only" CPR and use of an AED to all 7th graders in the San Ramon Valley School district. I have lobbied for mandatory CPR/AED training for all high school coaches and to have AED's at every high school sporting event (Not successful yet; but will be) in our state. This has to CHANGE!!!

    In sum, my survival has provided the stimulus to become a trained CPR/AED instructor, serve on the AHA 2020 Task Force, serve as a Board Member of PulsePoint Foundation and to volunteer within the SRVFD to help save lives and educate the public about important live saving techniques such as CPR/AED use and "heart" healthy living. Every day is a great day for me, since I am very fortunate to be on this planet. I am thankful also for my wife, children, friends, the paramedics and my rescuer who never gave up on me during the immediate hours of my SCA 6 years ago. I have been told that my "never give up attitude" probably contributed to my survival.

    Survivor Network

    If you have survived a sudden cardiac arrest or you are the spouse of a survivor – join us on the second Thursday of each month - Mended Hearts is dedicated to "Inspiring hope and improving the quality of life for heart patients and their families through ongoing peer-to-peer support"

    There will be educational presentations, time for questions to be answered and time to listen or share your experience with others.

    See Mended Hearts Support Group or call 925-947-5206.

  • Cardiac Arrest Receiving Centers

    A Cardiac Arrest Receiving Center is a hospital designated by Contra Costa County EMS with cardiac capabilities (cardiac catheterization, laboratory and/or cardiovascular surgery), designed to provide rapid, appropriate post arrest care.

    As of January 1, 2014, the following hospitals have been designated as Cardiac Arrest Receiving Centers in the Contra Costa County Cardiac Arrest System of Care:

    • John Muir Medical Center, Walnut Creek
    • John Muir Medical Center, Concord
    • Kaiser, Walnut Creek
    • San Ramon Regional Medical Center, San Ramon
    • Sutter Delta Medical Center, Antioch
    • Valley Care Medical Center, Pleasanton
    • Alta Bates Summit Medical Center – Summit Campus, Oakland

  • Cardiac Arrest System of Care Performance

    2014 Performance

    Graph under construction

    How We Measure Survival

    Contra Costa County Emergency Medical Services (CCCEMS) participates in CARES (Cardiac Arrest Registry to Enhanced Survival. CARES is a database developed by the CDC and Emory University that enables CCC EMS to perform internal benchmarking and improve the response to cardiac arrest by strengthening the chain of survival in our communities.
    - IOM brief on CARES

    Utstein Survival


    CPR Report

    Our cardiac monitors gather data on rhythms, compressions, ventilations, timing of shocks and other events. We can now create a CPR Report that summarizes these events. Feedback to crews in a timely fashion allows for post-event analysis - data, to improve care.

    We have set goals for compression rate and compression ratio (chest compression fraction).
    Compression ratio is greater than 80%
    Compression rate is to be between 100 and 120


Cardiac Arrest System of Care Program Medical Oversight:
David Goldstein, MD
EMS Medical Director