Original USA Today series from 2003: “Six Minutes to Live or Die”

The investigative series sponsored by the Kaiser Family Foundation was published in USA Today in 2003 revealed disparities in cardiac arrest survival rates among the nation’s emergency medical services. The series detailed factors that lead to better outcomes and showed that thousands more lives could be saved each year. USA Today republished one of the articles in the context of its 40th anniversary.

The newspaper no longer has the stories online, so the primary articles which appeared with many sidebar stories, graphics and photos are included here.

Key points included:

- Wide variations in cardiac arrest survival rates between cities, with top performers like Seattle saving 45% of victims, while many cities saved only 6-10%.

- Factors contributing to higher survival rates included accurate measurement of response times, strong medical oversight, resolving turf battles between fire and ambulance services, and public CPR training.

- Political leadership was crucial in improving EMS systems. In Boston, for example, Mayor Thomas Menino's commitment led to an increase in the cardiac arrest survival rate from 14% in 1993 to 40% in 2001.

- Civic engagement, particularly in CPR training and partnerships with local businesses to install AEDs, were key to successful EMS systems that saved the most lives.

- Alarmingly, most cities were not measuring patient survival or response times accurately.

- The lack of strong medical oversight, the presence of turf battles between fire and ambulance services, and the infrequency of public CPR prior to arrival contributed to low survival rates.

- We estimated that more than 1,000 lives could be saved annually if all cities performed better. Civic engagement was identified as a key factor in successful EMS systems.

-Seattle's high survival rates were partly attributed to its extensive public CPR training program, which had trained over 650,000 citizens since 1971.

- Boston's success was partly due to partnerships with local businesses to install defibrillators and train employees in their use.

- The investigations highlighted how strong leadership, both from political figures and within EMS organizations, could drive significant improvements and save lives. In September 2004, the findings were shared with the Institute of Medicine group working on the report Emergency Medical Services At The Crossroads, which determined that “heightened public awareness of problems that have been building over time has underscored the need for a review of the U.S. emergency care system.”

USA Today recognized the series as one of the top moments that mattered in its first 40 years.