Cardiac, respiratory and resuscitation medicine is rapidly changing with new protocols, procedures, thought processes, treatment devices, training and operations. More importantly, research and resuscitation outcomes are validating new approaches to care and driving new approaches to resuscitation. Consequently, care in the field must adapt.
This EMS State of the Science supplement, developed in cooperation with the U.S. Metropolitan Municipalities EMS Medical Directors Consortium and our sponsors, features articles that address key resuscitation issues.
The Medtronic Foundation’s Joan Mellor oversees the Foundation’s HeartRescue Project, a collaborative initiative designed to improve how SCA is recognized, treated and measured in the U.S. Most importantly, it’s an ambitious effort to change the way we collectively respond to sudden cardiac arrest (SCA). Partners involved in the project are working to improve SCA survival rates by 50% over five years by implementing measurable, evidence-based best practices among citizen bystanders; prehospital responders such as police, fire and EMS; and hospitals.
The quality of CPR and chest compressions are key factors for survival from cardiac arrest.1 Over the past 50 years, there has been a progressive increase in the recommended rate of chest compressions during CPR.In 1960, the recommended rate was 60 compressions/minute; this increased to at least 100 compressions/minute in the latest guidelines from the American Heart Association (AHA) in 2010.(1–4) However, guidance is not provided for a maximum chest compression rate.
The practice of reducing the core temperature of a cardiac arrest or stroke patient to protect the brain and increase the probability of a full return to normal function is rapidly gaining acceptance and practice in the EMS arena.
Recent investigations have demonstrated that a handful of communities have achieved remarkable cardiac arrest survival rates exceeding 15%. However, most Americans still live in locations with survival rates that are much lower. Many of the communities with high survival rates have achieved improved cardiac arrest outcomes by focusing on the entire chain of survival; that is, they support a full bundle of interventions to provide the best resuscitation care for patients with cardiac arrest. This “bundle of care” approach usually includes:
The importance of quality CPR for victims of cardiac arrest is beyond question. Real-time guidance and feedback on chest compression rates is already helping EMS teams perform better CPR. Now, more accurate feedback for chest compression depth is on the horizon, with a new application in development by Physio-Control.