International experts within emergency medical services and resuscitation have just entered a historic agreement about the establishment of a Global Resuscitation Alliance – a global network focused on collaborating to increase survival from sudden cardiac arrest. The participants commit themselves to the ambitious target of increasing survival rates by 50 percent. This agreement – signed in Copenhagen, Denmark and constituting the culmination of three decades of international work, is a major and decisive step in global efforts to save more lives from sudden cardiac arrest.
Experts from USA, Asia, Europe, the Middle East and Australia have just shaken hands on stepping up global efforts in order that, in the future, more people will survive sudden cardiac arrest. This agreement was entered at a so-called Utstein meeting, taking place in Copenhagen, Denmark, on 28-29 May – in advance of the first European congress on emergency medical services, EMS2016.
This new alliance is the result of a targeted effort towards enhanced survival rates that took its beginning in 1990, when experts convened at the first Utstein meeting in Norway to adopt a set of global guidelines for uniform reporting of sudden cardiac arrests. This came to mark the beginning of intensified collaboration efforts. Since then, a set of shared international guidelines concerning the treatment of sudden cardiac arrest has been adopted, and this has led to a significant improvement in the number of survivors. Now, Global Resuscitation Alliance, and thus the establishment of an organisation targeted at facilitating the implementation of best practices in the various countries, represents yet a huge step.
The foremost mission of the new global alliance will be to advance the dissemination and implementation of best-practice programmes within the field of emergency medical services and thereby to set new standards for emergency medical dispatch centers, ambulance services, and citizens’ involvement in resuscitation.
– Globally, survival rates after sudden cardiac arrest are extremely low; and in the most highly-developed countries, about one million people will die from sudden cardiac arrest on an annual basis. These are an unacceptably high rates; and, hence, we’ve taken initiatives to establish Global Resuscitation Alliance which is targeted at strengthening cooperative relationships between the countries. This is the result of many years’ dedicated work, and we’re extremely proud to see the alliance become a reality. This will come to be of incredible importance to many people, worldwide, says Michael Sayre, MD, Emergency Physician, University of Washington, Medical Director at the Seattle Fire Department, contributor to the Resuscitation Academy and co-initiator of Global Resuscitation Alliance.
Quicker and Better Treatment
When a person is suffering cardiac arrest, time and the quality of CPR is of the utmost importance to survival. For every minute that passes between the occurrence of sudden cardiac arrest and the initiation of CPR, the victim’s chance of survival will be reduced by about 10 percent. Thus, rapid alert, guidance in CPR from the emergency dispatch centers, lay people stepping in to provide assistance, and swift application and use of an AED together with an efficient and advanced pre-hospital care and in-hospital care are decisive factors for survival.
– Basically, it’s a matter of optimising every link in the survival chain. Today, we’ve extensive knowledge; and, likewise, we have an array of documented and efficient initiatives. In some countries, they’ve succeeded with first-responder programmes; whereas other countries succeeded in educating personnel at the emergency dispatch centers or paramedics or on the involvement of citizens and in increasing the number of AEDs. The initiatives proving to be most efficacious must be disseminated and applied globally. This will require that we share our knowledge concerning the challenges we’re facing with respect to the implementation of best practices, says Sang Do Shin, MD, MPH, PhD, Professor, National University College of Medicine in Seoul, Korea, and co-initiator of the Global Resuscitation Alliance.
Considerable Differences in Survival among Countries
Internationally, there are considerable differences – even among similar resource-rich countries with well-organised emergency medical services.
– In certain countries, only 3-5 percent of patients will survive sudden cardiac arrest, whereas – in e.g. Denmark – the survival rate is 12 percent. Even though, in Denmark, we’ve succeed in more than doubling survival rates within relatively few years, we must continue to strive towards even better results. The target set forth by our alliance – to increase survival rates for all countries by 50 percent, regardless of the starting point – is quite ambitious. However, we’re convinced that it can be achieved. We have recently seen very encouraging results from Seoul, Tokyo and Singapore, says Freddy Lippert, MD, Chief Executive Director, Emergency Medical Services Copenhagen, Denmark, Associate Professor at University of Copenhagen and co-initiator of the Global Resuscitation Alliance.
The need for a global network is obvious. That it’s launched at this very moment is because of the recommendation made by international experts on how to overcome barriers and to implement best practices in emergency medical services and to engage communities.
– It is extremely important – now, more than ever – that we learn from the most recent knowledge, documentation, education and technology and that we have a forum in which we can share our experiences. This alliance will accommodate a hitherto unsatisfied demand for systematising and sharing knowledge about resuscitation and for implementing such knowledge at a global level. This will enable us to provide the best possible treatment to the benefit of our patients; and we all share the hope that the alliance will provide the necessary results, says Tore Laerdal, Chief Executive Director of the Laerdal Foundation, Managing Director of Laerdal Global Health and co-initiator of the Global Resuscitation Alliance.
The Danish foundation, TrygFonden, a Danish non-commercial actor within emergency medical care, and a member of the Danish representation at the Utstein meetings, is also pleased by the alliance.
– During the most recent years, we’ve worked targeted towards involving the Danes in CPR and – to a very high extent – we’ve succeeded in changing the citizens’ attitude. Where the Danes were previously sceptical towards providing CPR, they are now much more prepared to step in. We look forward to sharing our positive experiences with the other countries and to become inspired, ourselves, into taking new initiatives that may make a difference in survival rates in Denmark, says Grethe Thomas, Project Director at TrygFonden and participant at the Utstein meeting, held in Copenhagen.
This Utstein meeting, supported and chaired by Laerdal Fonden and local Danish TrygFonden, was held in Copenhagen prior to the first European EMS congress, to be held from 30 May to 1 June. Read more here: www.ems2016.org
About Global Resuscitation Alliance
Global Resuscitation Alliance is the result of many years’ collaboration between the participating countries – dating back to 1990 when the first Utstein meeting was held in a remote monastery outside the town of Stavanger in Norway. Experts from all over the world convened at this meeting to adopt global guidelines for uniformed reporting on cardiac arrest that, subsequently, were disseminated to emergency medical services round the world. A number of subsequent Utstein meetings were all targeted at an enhancement of research, treatment and documentation aimed at increasing survival rates after sudden, unexpected cardiac arrest. The 2015 Utstein meeting identified an array of barriers preventing the countries from implementing the most recent knowledge and best-practice initiatives – and thus learning from one another. It was therefore decided to establish a global implementation organisation with the objective of assisting the countries in sharing best-practice experiences. With the establishment of Global Resuscitation Alliance, this has now become a reality.
The establishment of Global Resuscitation Alliance is, for instance, modelled on the successfully Resuscitation Academy in US that was established in 2009 for the purpose of increasing survival in USA together with extraordinary results achieved within the field of resuscitation in King County in Seattle, Washington. Here, they have 25 years of experience within the field, and they are internationally acknowledged as leading in resuscitation. Resuscitation Academy will be an important part of the new Global Resuscitation Alliance and, thus, their knowledge and experience will be disseminated to all membership countries.
The Global Resuscitation Alliance (GRA) mission:
- The GRA is committed to improving survival from sudden cardiac arrest.
- The GRA believes implementation of best resuscitation practices can save thousands of lives every year.
- GRA is committed to being a catalyst to improve resuscitation at the local level.
- The GRA believes programmatic improvement of EMS systems is possible and the vehicle to achieve this improvement is with local and regional Resuscitation Academies (RA) or organizations.
- The GRA is committed to helping train and motivate local leadership and provide that leadership with the resources and materials to offer RAs in their communities.
- The GRA will help provide the tools and training materials to provide high quality Resuscitation Academies.
Ten Steps to Improve Cardiac Arrest Survival Rates
1. Establish a cardiac arrest registry
2. Begin Dispatcher-assisted Telephone CPR with ongoing training and quality insurance
3. Begin high-performance EMS CPR with ongoing training and quality insurance
4. Begin rapid dispatch
5. Measure professional resuscitation using the defibrillator recording
6. Begin an AED program for first responders, including police officers, guards, and other security personnel.
7. Use smart technologies to extend CPR and public-access defibrillation programmes to notify volunteer bystanders who can respond to nearby cardiac arrest to provide early CPR and defibrillation
8. Make CPR and AED training mandatory at schools and in the community
9. Work towards accountability – submit annual reports to the community
10. Work towards a culture of excellence