The Chronicle
LEWIS COUNTY, Wash. — According to a report released by the Cardiac Arrest Registry to Enhance Survival (CARES), Washington state \, and Lewis County in particular, provide top-level pre-hospital care to people having heart attacks outside of hospitals.
The most recent full-year data from CARES covers the year 2024. Overall survival rates for out-of-hospital cardiac arrests not caused by trauma were 10.5% nationally, 14.1% in Washington state, and 13.5% in Lewis County.
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“In Lewis County, we have approximately 260 EMS responders to include paramedics, EMTs and first responders, of which 75% are volunteers,” said Lewis County EMS Council (LCEMSC) Chair Rich Underdahl in a news release. “All are dedicated to providing the best pre-hospital cardiac care for their communities. For a rural county, we are proud of the work performed by our responders, with the survival rate beating the national average and comparable to the state overall.”
Underdahl is the fire chief for Lewis County Fire District 20 in Vader and Fire District 15 in Winlock.
CARES data was presented by NW Cares Coordinator Jenny Shin at the December 2025 LCEMSC meeting. LCEMSC members represent all organizations providing 911 EMS response and patient care in Lewis County. This includes fire departments, Arbor Health Morton Hospital, Providence Centralia Hospital and private ground and air ambulance companies. Some non-response supporting organizations including Centralia College, law enforcement, elected officials and government agencies are members as well, according to the news release from CARES.
In addition to the overall survival numbers, Shin compared national, Washington state and Lewis County performance on individual data points. Also known as “key performance measures,” they gauge how well EMS responders provide care in the pre-hospital environment.
First, she showed who is having cardiac arrests outside of hospitals. The median age of people having cardiac arrests in Lewis County is 65, compared to 64 in Washington state and 66 nationally. The majority are male; 70% of people having cardiac arrests in Lewis County are male, compared to 66% in Washington state and 62% nationwide.
National data was also presented on where these cardiac arrests occurred. About 72% occurred at home, 18% to 20% occurred in a public location, and 8% to 11% in a nursing home.
The number of patients who survived to hospital discharge varied widely by where their cardiac arrest occurred — 21.0% in a public setting, 8.9% at home, and 4.4% in a nursing home. Patient survival rates nearly doubled when bystanders initiated CPR, according to the release.
“Responding to time-critical emergencies such as cardiac arrest is the most important thing our EMS and fire agencies do for the communities in Lewis County,” Lewis County’s EMS System Medical Program Director Dr. Peter McCahill said. “This data gives us a chance to look at how we are doing in this one very important area compared with the rest of the state and the rest of the country.”
“The report shows we are performing above the state and national averages in many important areas. This is fantastic to see and a testament to the hard work and incredible commitment from our providers, educators, chiefs and dispatchers,” McCahill continued. “Beyond our paid and volunteer professionals, there’s important information here for the community that shows the benefits of learning skills like CPR and knowing how to quickly access and use an AED.”
Data show that AEDs — automated external defibrillators — are rarely applied by a bystander prior to EMS arrival. Nationally, it occurs only 7% of the time.
The percentage for Washington state is 4% and 8% for Lewis County.
Shin pointed out how the highest survival rates were among those who had their cardiac arrest in a public place. This increases the likelihood where an AED might be available and used.
“More than 20% of cardiac arrest patients present with heart rhythms that can be corrected by an AED,” she said. “Learning to use an AED is part of the standard CPR course. Data collected prove that having more public access defibrillators in restaurants, stores, schools, law enforcement vehicles and public buildings helps save lives.”
CARES collects and reports out-of-hospital cardiac arrest survival rates for two main purposes. For EMS providers, it creates a uniform, reliable and accurate data base, the release stated. EMS systems and the communities they serve can use the data to make informed decisions on how to maintain and improve the effectiveness of their pre-hospital cardiac arrest patient care.
“There can always be improvement,” McCahill said. “I think the important thing about CARES is it identifies the critical elements in the chain of survival. Hopefully each of our districts and agencies and communities can take a look at these elements and work together to see how we can make the chain stronger for everyone in the county.”
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