EMS World Hall of Fame: Eisenberg, White

The short history of EMS has been driven by the wisdom, foresight, and innovation of countless individuals. As the field ages into its second half-century and its origins fade to the past, it’s worth commemorating the greatest pioneers of prehospital emergency medical services. This series honors these trailblazers. 

Mickey Eisenberg

CPR education

Another Seattle-area physician who has made essential contributions to the cause of cardiac arrest survival, Mickey Eisenberg, MD, PhD, MPH, is a professor emeritus in the University of Washington’s Department of Emergency Medicine and associate medical director for quality improvement with King County EMS. He has taught and studied CPR for more than 40 years. 

Among his accomplishments Eisenberg is known for helping spread CPR education through platforms like the famed Seattle/King County Resuscitation Academy (www.resuscitationacademy.org)—a twice-a-year 2-day boot camp of classes, demonstrations, and workshops to impart the knowledge and tools to improve cardiac survival across communities—and the University of Washington’s “Learn CPR” site. He is also the author of Resuscitate! How Your Community Can Improve Survival From Sudden Cardiac Arrest, first published in 2013. The book, which outlines steps EMS systems can take to improve SCA survival, is the official textbook of the Resuscitation Academy, and its second edition reflects lessons learned from academy attendees. 

A 2007 EMS World profile noted that at a time when some of the key components of a successful CPR system were only beginning to be fully appreciated—aspects like bystander CPR and early defibrillation via public access and by trained emergency responders—Eisenberg “was one of the first physicians to begin making them reality.”¹ As results in Seattle and King County improved, he helped bring them to national attention by publishing multiple landmark studies (ResearchGate credits him with some 274 bylines in scientific journals). As one barometer of this success, an astonishing 76% of those who suffered public cardiac arrests in Seattle/King County in 2020 got bystander CPR.²  

References

1. Barishansky R. Founding Fathers of EMS. EMS World. Published August 2007. Accessed March 7, 2022. www.hmpgloballearningnetwork.com/site/emsworld/article/10321743/founding-fathers-ems

2. Seattle & King County Public Health, Division of Emergency Medical Services. 2021 Annual Report. KingCounty.gov. Published September 2021. Accessed March 7, 2022.

Roger White

Improved cardiac outcomes

In 1964 Minnesota’s famed Mayo Clinic discontinued its ambulance service and contracted with a new local service, Gold Cross Ambulance, to continue coverage. The Rochester-based company was already making its name in the fledgling field of EMS as the state’s first service to require its members to be certified in first aid and later trained in CPR. A young cardiologist at the clinic, Roger White, began working with Gold Cross in 1970 and helped drive some landmark advances.

At the state’s request, White and Gold Cross developed training for rural ambulance attendants before the DOT’s initial 1971 EMT-A course. He also trained providers in delivering IVs, making Gold Cross the first service in the Upper Midwest to establish those in the field. But he is most associated with helping the system improve outcomes from cardiac arrest, for which Rochester became and has remained a national leader. 

White and colleagues chronicled their improvements in data. Among ventricular fibrillation OHCA patients, unadjusted survival in Rochester increased from 31.2% in the 1985–1990 period to 52.8% in the 2009–2015 period, and among VF patients with arrests witnessed by bystanders, it went from 35.7% to 63.5%.¹ 

Lots went into that, including high bystander CPR rates and optimized systems of care, but one unique factor was a longstanding culture of police involvement in rescue and medical assistance. Police operated Rochester’s ambulance service from the 1930s until Gold Cross’ arrival in ’62, then stayed active in pre-9-1-1 medical dispatch and first response. Their involvement in early CPR boosted the city’s survival rates significantly. White brought the first AEDs to patrol vehicles, and today all the city’s police cars carry them.  

Reference

1. Okubo M, Hess EP, Atkinson EJ, White RD. Abstract 14037: Improving Trend in Survival From Ventricular Fibrillation in Out-of-Hospital Cardiac Arrest in Rochester Minnesota. Circulation. 2016. Accessed March 4, 2022. www.ahajournals.org/doi/abs/10.1161/circ.134.suppl_1.14037?rss=1

John Erich is the senior editor of EMS World.