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Regional systems of care for out-of-hospital cardiac arrest: A policy statement from the American Heart Association. Circulation 2010 Feb 09;121(5):709-29

Date

01/16/2010

Pubmed ID

20075331

DOI

10.1161/CIR.0b013e3181cdb7db

Scopus ID

2-s2.0-76649130220 (requires institutional sign-in at Scopus site)   278 Citations

Abstract

Out-of-hospital cardiac arrest continues to be an important public health problem, with large and important regional variations in outcomes. Survival rates vary widely among patients treated with out-of-hospital cardiac arrest by emergency medical services and among patients transported to the hospital after return of spontaneous circulation. Most regions lack a well-coordinated approach to post-cardiac arrest care. Effective hospital-based interventions for out-of-hospital cardiac arrest exist but are used infrequently. Barriers to implementation of these interventions include lack of knowledge, experience, personnel, resources, and infrastructure. A well-defined relationship between an increased volume of patients or procedures and better outcomes among individual providers and hospitals has been observed for several other clinical disorders. Regional systems of care have improved provider experience and patient outcomes for those with ST-elevation myocardial infarction and life-threatening traumatic injury. This statement describes the rationale for regional systems of care for patients resuscitated from cardiac arrest and the preliminary recommended elements of such systems. Many more people could potentially survive out-of-hospital cardiac arrest if regional systems of cardiac resuscitation were established. A national process is necessary to develop and implement evidence-based guidelines for such systems that must include standards for the categorization, verification, and designation of components of such systems. The time to do so is now.

Author List

Nichol G, Aufderheide TP, Eigel B, Neumar RW, Lurie KG, Bufalino VJ, Callaway CW, Menon V, Bass RR, Abella BS, Sayre M, Dougherty CM, Racht EM, Kleinman ME, O'Connor RE, Reilly JP, Ossmann EW, Peterson E, American Heart Association Emergency Cardiovascular Care Committee, Council on Arteriosclerosis, Thrombosis, and Vascular Biology, Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation, Council on Cardiovascular Nursing, Council on Clinical Cardiology, Advocacy Committee, Council on Quality of Care and Outcomes Research

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

Emergency Medical Services
Heart Arrest
Humans
Myocardial Infarction
Public Health
Resuscitation
United States
Wounds and Injuries