Faculty Collaboration Database

Implementing the 2005 American Heart Association Guidelines improves outcomes after out-of-hospital cardiac arrest. Heart Rhythm 2010 Oct;7(10):1357-62

Date

04/28/2010

Pubmed ID

20420938

DOI

10.1016/j.hrthm.2010.04.022

Scopus ID

2-s2.0-77957255297 (requires institutional sign-in at Scopus site)   81 Citations

Abstract

OBJECTIVE: The purpose of the study was to determine whether applying highly recommended changes in the 2005 American Heart Association (AHA) Guidelines would improve outcomes after out-of-hospital cardiac arrest.

BACKGROUND: In 2005, AHA recommended multiple ways to improve circulation during cardiopulmonary resuscitation (CPR).

METHODS: Conglomerate quality assurance data were analyzed during prospective implementation of the 2005 AHA Guidelines in five emergency medical services (EMS) systems. All EMS personnel were trained in the key new aspects of the 2005 AHA Guidelines, including use of an impedance threshold device. The primary outcome was survival to hospital discharge. Secondary outcomes were return of spontaneous circulation (ROSC), survival by initial cardiac arrest rhythm, and the cerebral performance category (CPC) score at hospital discharge.

RESULTS: There were 1,605 patients in the intervention group and 1,641 patients in the control group. Demographics, the rate of bystander CPR, and time from the 911 call for help to arrival of EMS personnel were similar between groups. Survival to hospital discharge was 10.1% in the control group versus 13.1% in the intervention group (P = .007). For patients with a presenting rhythm of ventricular fibrillation/ventricular tachycardia, survival to discharge was 20% in controls versus 32.3% in the intervention group (P <.001). Survival to discharge with a CPC classification of 1 or 2 was 33.3% (10/30) in the control versus 59.6% (31/52) in the intervention group (P = .038).

CONCLUSIONS: Compared with controls, patients with out-of-hospital cardiac arrest treated with a renewed emphasis on improved circulation during CPR had significantly higher neurologically intact hospital discharge rates.

Author List

Aufderheide TP, Yannopoulos D, Lick CJ, Myers B, Romig LA, Stothert JC, Barnard J, Vartanian L, Pilgrim AJ, Benditt DG

Author

Tom P. Aufderheide MD Professor in the Emergency Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
American Heart Association
Cardiopulmonary Resuscitation
Emergency Medical Services
Female
Humans
Male
Middle Aged
Out-of-Hospital Cardiac Arrest
Patient Discharge
Practice Guidelines as Topic
Survival Rate
Tachycardia, Ventricular
Treatment Outcome
United States
Ventricular Fibrillation