The Cardiocerebral Resuscitation protocol for treatment of out-of-hospital primary cardiac arrest

Persistent Link:
http://hdl.handle.net/10150/610245
Title:
The Cardiocerebral Resuscitation protocol for treatment of out-of-hospital primary cardiac arrest
Author:
Ewy, Gordon
Affiliation:
University of Arizona Sarver Heart Center, University of Arizona, Tucson, AZ, 85704, USA
Issue Date:
2012
Publisher:
BioMed Central
Citation:
Ewy Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2012, 20:65 http://www.sjtrem.com/content/20/1/65
Journal:
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Rights:
© 2012 Ewy; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)
Collection Information:
This item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.
Abstract:
Out-of-hospital cardiac arrest (OHCA) is a significant public health problem in most westernized industrialized nations. In spite of national and international guidelines for cardiopulmonary resuscitation and emergency cardiac care, the overall survival of patients with OHCA was essentially unchanged for 30 years--from 1978 to 2008 at 7.6%. Perhaps a better indicator of Emergency Medical System (EMS) effectiveness in treating patients with OHCA is to focus on the subgroup that has a reasonable chance of survival, e.g., patients found to be in ventricular fibrillation (VF). But even in this subgroup, the average survival rate was 17.7% in the United States, unchanged between 1980 and 2003, and 21% in Europe, unchanged between 1980 and 2004. Prior to 2003, the survival of patients with OHCA, in VF in Tucson, Arizona was less than 9% in spite of incorporating previous guideline recommendations. An alternative (non-guidelines) approach to the therapy of patients with OHCA and a shockable rhythm, called Cardiocerebral Resuscitation, based on our extensive physiologic laboratory studies, was introduced in Tucson in 2003, in rural Wisconsin in 2004, and in selected EMS areas in the metropolitan Phoenix area in 2005. Survival of patients with OHCA due to VF treated with Cardiocerebral Resuscitation in rural Wisconsin increased to 38% and in 60 EMS systems in Arizona to 39%. In 2004, we began a statewide program to advocate chest compression-only CPR for bystanders of witnessed primary OHCA. Over the next five years, we found that survival of patients with a shockable rhythm was 17.7% in those treated with standard bystander CPR (mouth-to-mouth ventilations plus chest compression) compared to 33.7% for those who received bystander chest-compression-only CPR. This article on Cardiocerebral Resuscitation, by invitation following a presentation at the 2011 Danish Society Emergency Medical Conference, summarizes the results of therapy of patients with primary OHCA treated with Cardiocerebral Resuscitation, with requested emphasis on the EMS protocol.
EISSN:
1757-7241
DOI:
10.1186/1757-7241-20-65
Keywords:
Ventricular fibrillation; Resuscitation; Cardiac arrest; Cardiopulmonary resuscitation; Cardiocerebral resuscitation; Primary cardiac arrest; Emergency medical system; Out-of-hospital cardiac arrest
Version:
Final published version
Additional Links:
http://www.sjtrem.com/content/20/1/65

Full metadata record

DC FieldValue Language
dc.contributor.authorEwy, Gordonen
dc.date.accessioned2016-05-20T09:02:05Z-
dc.date.available2016-05-20T09:02:05Z-
dc.date.issued2012en
dc.identifier.citationEwy Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2012, 20:65 http://www.sjtrem.com/content/20/1/65en
dc.identifier.doi10.1186/1757-7241-20-65en
dc.identifier.urihttp://hdl.handle.net/10150/610245-
dc.description.abstractOut-of-hospital cardiac arrest (OHCA) is a significant public health problem in most westernized industrialized nations. In spite of national and international guidelines for cardiopulmonary resuscitation and emergency cardiac care, the overall survival of patients with OHCA was essentially unchanged for 30 years--from 1978 to 2008 at 7.6%. Perhaps a better indicator of Emergency Medical System (EMS) effectiveness in treating patients with OHCA is to focus on the subgroup that has a reasonable chance of survival, e.g., patients found to be in ventricular fibrillation (VF). But even in this subgroup, the average survival rate was 17.7% in the United States, unchanged between 1980 and 2003, and 21% in Europe, unchanged between 1980 and 2004. Prior to 2003, the survival of patients with OHCA, in VF in Tucson, Arizona was less than 9% in spite of incorporating previous guideline recommendations. An alternative (non-guidelines) approach to the therapy of patients with OHCA and a shockable rhythm, called Cardiocerebral Resuscitation, based on our extensive physiologic laboratory studies, was introduced in Tucson in 2003, in rural Wisconsin in 2004, and in selected EMS areas in the metropolitan Phoenix area in 2005. Survival of patients with OHCA due to VF treated with Cardiocerebral Resuscitation in rural Wisconsin increased to 38% and in 60 EMS systems in Arizona to 39%. In 2004, we began a statewide program to advocate chest compression-only CPR for bystanders of witnessed primary OHCA. Over the next five years, we found that survival of patients with a shockable rhythm was 17.7% in those treated with standard bystander CPR (mouth-to-mouth ventilations plus chest compression) compared to 33.7% for those who received bystander chest-compression-only CPR. This article on Cardiocerebral Resuscitation, by invitation following a presentation at the 2011 Danish Society Emergency Medical Conference, summarizes the results of therapy of patients with primary OHCA treated with Cardiocerebral Resuscitation, with requested emphasis on the EMS protocol.en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.urlhttp://www.sjtrem.com/content/20/1/65en
dc.rights© 2012 Ewy; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)en
dc.subjectVentricular fibrillationen
dc.subjectResuscitationen
dc.subjectCardiac arresten
dc.subjectCardiopulmonary resuscitationen
dc.subjectCardiocerebral resuscitationen
dc.subjectPrimary cardiac arresten
dc.subjectEmergency medical systemen
dc.subjectOut-of-hospital cardiac arresten
dc.titleThe Cardiocerebral Resuscitation protocol for treatment of out-of-hospital primary cardiac arresten
dc.typeArticleen
dc.identifier.eissn1757-7241en
dc.contributor.departmentUniversity of Arizona Sarver Heart Center, University of Arizona, Tucson, AZ, 85704, USAen
dc.identifier.journalScandinavian Journal of Trauma, Resuscitation and Emergency Medicineen
dc.description.collectioninformationThis item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.en
dc.eprint.versionFinal published versionen
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