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Wednesday, December 12, 2012

MICR still paying off

Cardiac Arrest Survival Rates Triple For Ariz. FD

Survival rates have more than tripled for cardiac arrest patients in the Northwest Fire District (NWFD) as a result of a new treatment protocol and a close partnership with the University of Arizona Medical Center.

(see article at

Essentially, the overall survival rate has gone from 4.9% to 14.6% for all arrests and from 11.1% to 37.5% for witnessed arrests.

This builds on the MICR work Bobrow et al. published in JAMA in March 2008.

The enabler was a focus on the issues, minimization of interruptions, and postponing or eliminating intubation. The JAMA article announced a similar percentage gain: "Among the 886 patients in the 2 metropolitan cities, survival-to-hospital discharge increased from 1.8% (4/218) before MICR training to 5.4% (36/668) after MICR training (odds ratio [OR], 3.0; 95% confidence interval [CI], 1.1-8.9). In the subgroup of 174 patients with witnessed cardiac arrest and ventricular fibrillation, survival increased from 4.7% (2/43) before MICR training to 17.6% (23/131) after MICR training (OR, 8.6; 95% CI, 1.8-42.0)." That's more than a three-fold improvement in just shy of three years. 

The more than three-fold improvement just reported was reached within 8 months of the implementation of MICR principles.

Has your EMS implemented MICR?