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San Francisco EMS aims to double cardiac‑arrest survival with 20/20/50 target; expands AED, training and data efforts
Summary
City EMS leaders presented '20/20/50' to reach a 50% survival rate for witnessed, shockable out‑of‑hospital cardiac arrest by 2020 and outlined broader '20/20/60' chronic‑disease initiatives. Plans include targeted AED placements, PulsePoint app rollout, improved EKG transmission and community CPR training.
San Francisco Emergency Medical Services officials outlined a plan to substantially increase survival after out‑of‑hospital cardiac arrest and to reduce the burden of cardiovascular disease through targeted clinical and community interventions.
“We say at the end of 2020 what we would like in our city here is a 50 percent survival rate of somebody that has a witnessed cardiac arrest that has some type of CPR, or AED … and they're resuscitated and they walk out of the hospital with neurologic function intact,” EMS Administrator James Stern said, describing the '20/20/50' initiative. EMS Medical Director John Brown and Stern reviewed system improvements since the 2017 transition, including revised policies, new training, and a fellowship program.
EMS staff showed maps of AED registrations that revealed geographic disparities — more AEDs downtown and fewer in some west and south neighborhoods — and described plans to use grant funds, corporate partnerships and community fundraisers to place more devices. Brown noted potential legislative approaches to require AEDs in some high‑risk settings and explained new monitoring technologies that can track AED battery status and pad expiration.
PulsePoint, an app linked with dispatch, will notify trained bystanders of nearby public cardiac arrests and the nearest registered AED. Brown described improvements in prehospital care data: transmission of 12‑lead EKGs to hospitals rose from near zero to about 80 percent in recent months, enabling faster cath‑lab activation for STEMI patients.
EMS also described a '20/20/60' initiative to lower congestive heart failure, hypertension and diabetes complications by shortening time to reperfusion and improving care coordination; pilots include community paramedicine programs and data‑driven intervention targeting. Commissioners encouraged partnerships with schools, Boys & Girls Clubs and the DMV to expand CPR training and to place training kiosks in public locations. EMS said it will return with more data and a report on regulatory responsibilities.
