are basic with advanced life support units, emergency BLS only, and non-emergency BLS only. The first tier is basic life support provided by cross-trained firefighter emergency medical technician - basics. The second tier is advanced life support. Basic life support transports for 9-1-1 calls are provided by either a fire department or one of the private ambulance companies American Medical Response and Tri-Med Ambulance. Advanced life support transports for 9-1-1 calls are provided by paramedics. Education All paramedics in King County are graduates of the University of Washington Paramedic Training Program regardless of previous training. The training is 1,866 total hours consisting of 380 lecture hours, 120 lab hours, 466 clinical hours in the operating room and emergency department at Harborview Medical Center and critical care unit and labor and delivery at Seattle Children's Hospital, and 900 field internship hours with Seattle Medic One. Students see an average of 700 patient contacts. Improvement The paramedic medical director for the one of six Medic One programs that provided care reviews every resuscitation, intubation, and central-line placement attempt. That director provides both positive and negative feedback. For probationary paramedics a more rigorous review is conducted. Funding Medic One paramedic programs are funded by a property tax levy. Basic life support services receive partial funding from the levy. The levy passed in 1979, 1985, 1991, 1998, 2001, and 2008. The levy did not pass in 1997. The Medic One Foundation is a nonprofit charitable foundation supporting paramedic training, research, medical oversight and quality review, and the purchasing of emergency medical equipment. Performance Cardiac arrest A change in the protocol of emergency response personnel is also credited as contributing to the high survival rate in the region. Guidelines set by the American Heart Association in 2000, recommend repeated shocks from a defibrillator and to check for a pulse prior to starting CPR. Medic One guidelines, established in 2005, are to provide a single shock from a defibrillator followed immediately by two minutes of CPR, beginning with chest compressions. This has dropped the average time between first shock to starting CPR from twenty-eight seconds to seven seconds, resulting in a near 50% increase in the previous rate of survival. For every one hundred cardiac arrest calls, now an additional thirteen patients will live. In King County outcomes of attempted out-of-hospital resuscitations are recorded, following the Utstein uniform reporting guidelines, in a cardiac arrest registry. In