Improving cardiac arrest survival by providing high quality, co-ordinated care: 2010 International Liaison Committee on Resuscitation guidelines

Therapy ◽  
2011 ◽  
Vol 8 (6) ◽  
pp. 721-730 ◽  
Author(s):  
Comilla Sasson ◽  
Pascal Meier ◽  
Jenny A Campbell ◽  
Jason S Haukoos ◽  
David J Magid ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
High Quality ◽  
Liaison Committee ◽  
Resuscitation Guidelines ◽  
Cardiac Arrest Survival

scholarly journals Therapeutic hypothermia after cardiac arrest

2016 ◽  
Vol 63 (2) ◽  
pp. 15-18
Author(s):  
A. Iglica ◽  
K. Aganovic ◽  
A. Godinjak ◽  
A. Mujakovic ◽  
S. Jusufovic ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Therapeutic Hypothermia ◽  
Supportive Therapy ◽  
Heart Association ◽  
Term Survival ◽  
Liaison Committee ◽  
Shockable Rhythm ◽  
Resuscitation Guidelines ◽  
Hospital Cardiac Arrest

Therapeutic hypothermia in selected patients surviving sudden out-of-hospital cardiac arrest can significantly improve rates of long-term survival and is considered as one of the most important clinical advancements in the science of resuscitation. Since 2003 the American Heart Association/International Liaison Committee on Resuscitation guidelines endorsed the use of hypothermic therapies as standard care for patients suffering from cardiac arrest while in 2005 additional inclusion and exclusion criteria were applied to patients experiencing in or out-of-hospital cardiac arrest with an initial shockable and non shockable rhythm. The goals of treatment in 2015 include achieving targeted temperature as quickly as possible with immediate initiation of cooling methods accompanied with supportive therapy and controlled rewarming.

Abstract P89: Take Heart America ™ : A Community-based Sudden Cardiac Arrest Survival Initiative is Saving Lives by Implementing the Most Highly Recommended 2005 American Heart Association Resuscitation Guidelines

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Keith Lurie ◽  
Janet Steinkamp ◽  
Charles Lick ◽  
Tom Aufderheide ◽  
Michael Sayre ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Phase Ii ◽  
Survival Rates ◽  
Sudden Cardiac Arrest ◽  
Heart Association ◽  
Community Based ◽  
Chi Square ◽  
Resuscitation Guidelines ◽  
Chi Square Analysis ◽  
Cardiac Arrest Survival

Introduction: Take Heart America (THA) is a community-based initiative intended to improve survival from sudden, out-of-hospital cardiac arrest (OHCA) in four US communities: St. Cloud (MN), Anoka County (MN), Columbus (OH) and Austin (TX). Hypothesis: Implementing a continuum of resuscitation care that includes the most highly recommended 2005 AHA resuscitation guidelines will improve survival from OHCA. Methods: In Phase I, the two MN sites (population: greater St. Cloud: ~160K; Anoka Co: ~320K) implemented: a) widespread CPR training in schools and businesses; b) retraining of all EMS personnel in methods to enhance circulation including minimizing CPR interruptions, performing CPR prior to and after single shock defibrillation, and use of an impedance threshold device; c) more widespread deployment of AEDs in schools and public places; and d) transport to and treatment by Level One Cardiac Arrest Centers that provide: therapeutic hypothermia (applied to all comatose patients regardless of initial arrest rhythm), coronary artery evaluation and treatment, and widespread electrophysiological evaluation. During Phase II, Austin and Columbus will implement these same steps. A Standard Chi-Square analysis was performed. Results: From 2006 –2007 in the two MN sites, >12,000 people were trained in CPR, bystander CPR rates increased by ~5%, three Level One Cardiac Arrest Centers were established, and interventions a–d above were fully implemented. Survival in all patients following OCHA improved from 9.3% (14/151) in 2005 (historical control) to 17% (31/181) (P=0.0373) in 2007 in these two sites. Conclusions: In conclusion, when OHCA patients were treated with a continuum of prehospital and inhospital interventions intended to optimize defibrillation and circulation during CPR, and preserve heart and brain function following cardiac arrest, survival rates nearly doubled when compared to historical controls. The THA initiative is effective in mid-size communities, but regular retraining of EMS personnel is needed to assure full implementation of the key aspects of the program. Phase II is underway to determine if the program can be successfully implemented with similar positive results in communities with populations of 500 –1000K.

scholarly journals Improvement of out-of-hospital cardiac arrest survival rate after implementation of the 2010 resuscitation guidelines

PLoS ONE ◽  
2018 ◽  
Vol 13 (9) ◽  
pp. e0204169 ◽  
Author(s):  
Robert Larribau ◽  
Hélène Deham ◽  
Marc Niquille ◽  
François Pierre Sarasin
Keyword(s):  
Cardiac Arrest ◽  
Survival Rate ◽  
Resuscitation Guidelines ◽  
Cardiac Arrest Survival ◽  
Hospital Cardiac Arrest

scholarly journals LO01: Analysis of bystander CPR quality during out-of-hospital cardiac arrest using data derived from automated external defibrillators

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S6-S6
Author(s):  
S. M. Fernando ◽  
C. Vaillancourt ◽  
S. Morrow ◽  
I. G. Stiell
Keyword(s):  
Cardiac Arrest ◽  
Compression Rate ◽  
High Quality ◽  
Shock Delivery ◽  
Automated External Defibrillators ◽  
Resuscitation Guidelines ◽  
Bystander Cpr ◽  
Cpr Quality ◽  
Hospital Cardiac Arrest

Introduction: Out-of-hospital cardiac arrest (OHCA) is associated with high mortality, and CPR quality is one of the few modifiable factors associated with improved outcomes. Particularly, bystander CPR has been shown to improve survival and neurological outcomes in OHCA. However, the quality of CPR performed by bystanders in OHCA is unknown. We evaluated bystander CPR quality during OHCA, utilizing data stored within Automated External Defibrillators (AEDs), and matched with cases enrolled in the Resuscitation Outcomes Consortium (ROC) database. Methods: This cohort study included adult OHCA cases from the Ottawa ROC site between 2011-2016, which were of presumed cardiac etiology, not witnessed by EMS, and where an AED was utilized by a bystander with > 1 minute of CPR process data available. AED data from Ottawa Paramedic Services was matched to each case identified by the ROC database. AED data was analyzed using manufacturer software to determine overall measures of bystander CPR quality, changes in bystander CPR quality over time, and bystander adherence to existing 2010 Resuscitation Guidelines. Results: 100 cases met all inclusion criteria. 75.0% of patients were male, with a mean age of 62.3 years. 58.0% of arrests occurred in the home setting, and 24.0% were witnessed arrests. Initial rhythm was ventricular fibrillation/ventricular tachycardia in 36.0% of cases. Overall survival rate was 42.0%, with a modified Rankin Score of 3.7 (95% CI: 2.9-4.5). Bystanders demonstrated high-quality CPR over the course of resuscitation, with a chest compression fraction (CCF) of 75.9% (73.6-78.1), a compression depth of 5.26 cm (5.03-5.49), and a compression rate of 111.2/min (107.7-114.7). Mean peri-shock pause was 26.8 seconds (24.6-29.1). Adherence rates to 2010 Resuscitation Guidelines for compression rate and depth were 66.0% (60.9-71.1) and 54.9% (48.6-61.3), respectively. CPR quality was lowest in the first minute of resuscitation, during which rhythm analysis took place (mean 40.5 sec). In cases involving a shockable rhythm, overall latency from initiation of AED to shock delivery was 59.2 sec (45.5-72.8). Conclusion: We found that bystanders perform high-quality CPR, with strong adherence rates to existing Resuscitation Guidelines. Our findings provide evidence of the quality of bystander CPR performed during OHCA.

scholarly journals The Effect of Implementing Mechanical Cardiopulmonary Resuscitation Devices on Out-of-Hospital Cardiac Arrest Patients in an Urban City of Taiwan

2021 ◽  
Vol 18 (7) ◽  
pp. 3636
Author(s):  
Yi-Rong Chen ◽  
Chi-Jiang Liao ◽  
Han-Chun Huang ◽  
Cheng-Han Tsai ◽  
Yao-Sing Su ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Primary Outcome ◽  
Medical Service ◽  
Spontaneous Circulation ◽  
High Quality ◽  
Urban City ◽  
Service Response Time ◽  
Mechanical Cpr ◽  
Hospital Cardiac Arrest

High-quality cardiopulmonary resuscitation (CPR) is a key element in out-of-hospital cardiac arrest (OHCA) resuscitation. Mechanical CPR devices have been developed to provide uninterrupted and high-quality CPR. Although human studies have shown controversial results in favor of mechanical CPR devices, their application in pre-hospital settings continues to increase. There remains scant data on the pre-hospital use of mechanical CPR devices in Asia. Therefore, we conducted a retrospective cohort study between September 2018 and August 2020 in an urban city of Taiwan to analyze the effects of mechanical CPR devices on the outcomes of OHCA; the primary outcome was attainment of return of spontaneous circulation (ROSC). Of 552 patients with OHCA, 279 received mechanical CPR and 273 received manual CPR, before being transferred to the hospital. After multivariate adjustment for the influencing factors, mechanical CPR was independently associated with achievement of any ROSC (OR = 1.871; 95%CI:1.195–2.930) and sustained (≥24 h) ROSC (OR = 2.353; 95%CI:1.427–3.879). Subgroup analyses demonstrated that mechanical CPR is beneficial in shorter emergency medical service response time (≤4 min), witnessed cardiac arrest, and non-shockable cardiac rhythm. These findings support the importance of early EMS activation and high-quality CPR in OHCA resuscitation.

Abstract 13721: The Monitoring of rSO2 Value During CPR is Useful for High-Quality CPR

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Yoshihito Ogawa ◽  
Tadahiko Shiozaki ◽  
Tomoya Hirose ◽  
Mitsuo Ohnishi ◽  
Goro Tajima ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Chest Compression ◽  
Clinical Utility ◽  
Spontaneous Circulation ◽  
Regional Cerebral Oxygen Saturation ◽  
High Quality ◽  
Specificity And Sensitivity ◽  
Single Center Study ◽  
Manual Chest Compression ◽  
Hospital Cardiac Arrest

[Background] Recently, the patients with out-of-hospital cardiac arrest are increasing. It is very important to do chest compression continuously for the return of spontaneous circulation (ROSC). But we can not but stop chest compression during checking pulse every few minutes. We reported that Regional cerebral Oxygen Saturation (rSO2) value was not elevated by manual chest compression and mechanical chest compression increased a little rSO2 value on CPR without ROSC and rSO2 value became a good parameter of ROSC in single center study. [Purpose] The purpose of this study is to evaluate clinical utility of rSO2 value during CPR in multicenter study. [Method] Retrospectively, we considered the rSO2 value of the out-of -hospital cardiac arrest patients from December 2012 to December 2014 in multicenter. During CPR, rSO2 were recorded continuously from the forehead of the patients by TOS-OR (Japan). CPR for patients with OHCA was performed according to the JRC-guidelines 2010. [Result] 252 patients with OHCA were included in this study. The rSO2 value on arrival, during CPR and ROSC were 44.4±8.9%, 45.4±9.7%, 58.6±9.2%. In ROSC, with rSO2 cutoff value of 52.7%, the specificity and sensitivity were 80% and 79%, respectively. The negative predict value was 99.2%, respectively. It means little possible to ROSC, if the rSO2 value is less than 52.7%. So, it may be possible to reduce the frequency of checking pulse during CPR. [Conclusion] The monitoring of rSO2 value could reduce the frequency of checking pulse during CPR and do chest compression continuously.

Abstract 17116: Incidence and Outcomes of Out-of-hospital Maternal Cardiac Arrest and Compliance With Resuscitation Guidelines

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Alan A Lipowicz ◽  
Sheldon Cheskes ◽  
Sarah H Gray ◽  
Farida Jeejeebhoy ◽  
Janice Lee ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Performance Metrics ◽  
Point Of Care ◽  
Survival Rates ◽  
Rare Event ◽  
Population Based ◽  
Childbearing Age ◽  
Child Bearing ◽  
Resuscitation Guidelines ◽  
Regional Health Authorities

Background: Published survival rates after out-of-hospital cardiac arrests (OHCA) are lower than in-hospital cardiac arrest (IHCA). Current estimates for the incidence and rate of survival for maternal cardiac arrest are published only for IHCA. There are no studies that report the incidence and outcomes of maternal OHCA. Current cardiopulmonary resuscitation guidelines contain specific maternal recommendations, although compliance with recommended benchmarks has not been reported. The objective of this study was to report maternal OHCA incidence, outcomes, and compliance with resuscitation and maternal specific guidelines. Methods: This was a population-based cohort study of consecutive maternal OHCA between May 2010 and April 2014. The denominator was estimated from the total regional population of all women of childbearing age obtained from census and age-specific pregnancy rates provided by regional health authorities. Resuscitation performance was measured against the 2010 AHA Guidelines. Results: A total of 6 maternal OHCA occurred amongst 1,085 OHCA occurring in females of child bearing age (15-49) over 4yrs; Incidence-1.85:100,000 (95% CI 1.76 to 1.95) vs. 19.4 per 100,000 (95% CI, 19.37 to 19.43). Maternal and neonatal survival to discharge was 16.7% and 33.3%, respectively. Compliance with CPR quality metrics averaged 83% with a range from 75% to 100%. Compliance with maternal-specific resuscitation guidelines averaged 46.9%, with a range from 0% to 100%. The only performance metrics with 100% compliance was intravenous line insertion above the diaphragm and prehospital activation of the maternal cardiac arrest team. Uterine displacement compliance was low at 0%. Conclusion: The incidence of maternal OHCA was 1.85:100,000, which is lower than the published estimate for maternal IHCA. Survival after OHCA for mother and for child was higher than OHCA occurring in non-pregnant adult females of child bearing age; however, the number of survivors was small (<5). Compliance rates with recommended resuscitation guidelines were high, yet compliance with maternal-specific guidelines were low suggesting targeted training and implementation optimization at the point of care is required to prepare for this rare event involving two lives.

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