Leadership and Legacy
In 1969, Seattle Cardiologist Dr. Cobb championed the cause of bringing improved cardiac care to Seattle. He is responsible for the concept of taking the coronary care unit from the hospital to the patient. Medic One was born. His leadership and drive created a system that still rivals any in the world. Prior to 1969 there was no cardiac response as we know it today. Fire department aid units and ladder trucks would respond to calls. Ambulances would be called and sometimes more than an hour would pass before a patient would get to the hospital.
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Dr. Cobb approached then Fire Chief Gordon Vickery with the idea of using the fire department aid units as first responders. Chief Vickery embraced the idea. "I
think about year 2-4 we noted that we would send out the fire engine with an
aid car or a medic unit with an aid car and not everyone in the fire department
knew how to do CPR. It was new! It was relatively new about 10 years
old. So we got Chief Vickery to have everybody
on active duty in the fire department trained to do CPR. They would get their first or majority of
their time on an engine or aid car and they would do CPR until the medics
arrive. So Vickery one day said to me, 'you
know, if you can teach fireman to do it in a relatively short period of
time. Why not try the general public?'” -Dr. Cobb
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"Copass
was a resident here at Harborview. And he got interested in what was going on
in the emergency room, seeing the medics being trained. So he wanted to see if
he could help with the training program and some of the supervision as well. So
Copass, he was a neurology resident, so not really thought of as emergency
medicine. So anyhow, he had just gotten out of the army and we kind of keyed in
on it, so he took over the training program. And we had two or three people
running it before that, but Copass really made it go. He put his heart and soul
into it, and did a lot of the things we talked about; exponential training,
making sure that they saw firsthand what they were going to be dealing with,
and received instruction while they were working with the seniors[instructors]. And this is
a development that Copass, for 10 years, sort of metamorphosized the program that
involved him. It’s probably the best training program in the country, if not
the world. It is largely Dr. Copass’s business." -Dr. Cobb
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When you look at the impressive recovery rates in Seattle it is natural to ask, "What has made the biggest difference. What makes a s successful emergency response system?" "There isn’t any one point. You have to get there quickly to the patient, you
have to do the right thing, rapid response, getting the patient incubated, CPR
done without interruption, administration of drugs. They all have to be done, and
they have to be done quickly, and in an organized way. There isn’t a single
thing that you can say, it doesn’t work that way. You can take one thing, you
can have a rapid response which is obviously as important as any, but it doesn’t
do any good to have a rapid response if nothing useful is done after the people
that respond arrive at the scene. This is a natural question, but you have to
have everything working this to be affective. " - Dr. Cobb
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The leadership of Dr. Cobb and Gordon Vickery early in the development of Seattle's emergency response system collectively known as Medic One is based on a philosophy of continually trying to improve.
"I think it is because of the leadership and the same things we talked about in the beginning of the discussion. The idea of looking critically at what we are doing on an ongoing basis. The montra for that is to measure and improve. If you’re not measuring something, it’s hard to know if you’re improving at it. And literally for cardiac arrest, we measure, record, capture the entire resuscitation literally second by second. We can look at the heart rhythm, we can look at the chest compressions, we can look at the medications we gave, when we shocked the heart, and just careful attention to detail and trying to do a little bit better every day. " -Captain Larsen.