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Thursday, September 9, 2010

Studies offer insight into potential CPR standard changes

  1. There is no advantage in performing full CPR vs compression-only CPR in many sudden cardiac arrest situations.
  2. There is a significant benefit to using an AED before the EMS arrives.
THE DETAILS:We need to strengthen the pre-arrival link in the chain of survival if we are to reduce the number of these deaths

By Art Hsieh
EMS1 Editorial Advisor

As the countdown continues toward the fall release of the American Heart Association Guidelines for emergency cardiac care, studies continue to provide insight into potential changes. Two such articles came across my Google Reader that I'd like to share.

The first is titled "CPR with Chest Compression Alone or with Rescue Breathing" and was conducted in both the United States (King and Thurston Counties, Wash.) and the United Kingdom (London).

The researchers wanted to find out if there were any differences in outcome in cardiac arrest based on whether bystanders were instructed to provide mouth to mouth rescue breathing, or if they were instructed to perform only chest compressions.

The results indicate that there were no differences in overall survival to discharge. There were "favorable trends" for performing compression-only CPR for patients who suffered sudden death from a cardiac cause, and there appeared to be an improvement in neurological outcome as well.

The second article looked at the prevalence of public access defibrillation (PAD) and its impact on survival. "Survival After Application of Automatic External Defibrillators Before Arrival of the Emergency Medical System" is based on research being performed with the Resuscitation Outcomes Consortium (ROC), a multicenter, multiregional study group spread across the United States.

In this study, researchers looked at the impact of PAD in patients experiencing out of hospital cardiac arrests (OHCA). They found significant differences in survival to hospital discharge in those patients who had bystander CPR performed but did not receive pre-EMS defibrillation in public areas (9 percent), compared to those who did have an AED applied and a shock delivered (38 percent).

These studies continue to reinforce the notion that EMS must continue to participate in community-based activities that promote an immediate and appropriate bystander response to sudden cardiac arrest.

SCA continues to be our number one killer in the United States. We need to strengthen the pre-arrival link in the chain of survival if we are to reduce the number of these deaths.

About the author

EMS1 Editorial Advisor Art Hsieh, MA, NREMT-P is the Chief Executive Officer and Education Director of the San Francisco Paramedic Association. In the profession since 1982, Art has worked as a line medic and chief officer in both third service and fire-based EMS. He has directed both primary and EMS continuing education programs. A Past President of the National Association of EMS Educators, and a scholarship recipient of the American Society of Association Executives, Art is a published textbook author and has presented at conferences nationwide.