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Improved Survival from Cardiac Arrest in the Community
Author(s) -
HEARNE THOMAS R.,
CUMMINS RICHARD O.
Publication year - 1988
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1988.tb06336.x
Subject(s) - medicine , defibrillation , cardiopulmonary resuscitation , medical emergency , chain of survival , resuscitation , emergency medical services , ventricular fibrillation , intensive care medicine , ambulance service , asystole , basic life support , emergency medicine
We now know that the elements required to achieve the highest survival rates from out‐of‐hospital cardiac arrest include: witnessed arrest, rapid telephone notification of the emergency medical service, early initiation of cardiopulmonary resuscitation, rapid arrival within minutes of emergency personnel equipped with a defibrillator, and early advanced airway management and intravenous pharmacology. In the United States, and in several other countries innovative approaches have been tried to bring all these elements together in one system. These approaches include community‐wide CPR training programs, telephone‐assisted CPR instruction delivered at the time of a cardiac arrest, early defibrillation performed by family members of high risk patients, early defibrillation performed by minimally trained community responders, and early defibrillation performed by minimally trained ambulance personnel. Controlled, prospective studies have demonstrated the effectiveness and practicality of all of these approaches. New studies are in progress with the prehospital use of early transcutaneous cardiac pacing and these show promise. This article reviews the evidence that supports these multi‐layered and innovative approaches to the treatment of out‐of‐hospital cardiac arrest.