Emergency Physicians Reveal Strategies for Improving Sudden Cardiac Arrest Survival Rates in the U.S.

PRNewswire/ -- A new State of Resuscitation survey released today by the American College of Emergency Physicians (ACEP) finds an overwhelming majority (90 percent) of the emergency physicians surveyed believe that resuscitation practices in the United States are not very effective. Emergency physicians cite increased bystander CPR, faster patient-to-doctor time, improved data collection and sharing, and greater use of technology as critical to improving resuscitation for victims of sudden cardiac arrest (SCA).

"While we've made significant advances to improve resuscitation efforts, more needs to be done. The State of Resuscitation survey offers valuable insights on how we can build upon already existing practices, including increasing public involvement and implementing technology to help save more lives," said Dr. Nick Jouriles, president of ACEP. "The results clearly show that it is necessary for communities to encourage more CPR trainings, offer more access to a broader range of critical life-saving technologies, and report sudden cardiac arrest cases more consistently."

The survey shows that 9 out of 10 respondents (88 percent) consider bystander intervention an important factor to increase survival. Other factors viewed as having a positive impact on survival rates include faster patient-to-doctor time (77 percent), data collection and sharing (73 percent), automated technologies (66 percent), and real-time feedback on compressions (65 percent).

"The optimal treatment of patients who suffer out-of-hospital cardiac arrest requires a well-coordinated system of community members, emergency medical services (EMS), emergency department, cardiology and critical care services," said Arthur B. Sanders, M.D., professor of emergency medicine at University of Arizona Health Sciences Center. "Community programs include early access to the EMS system and training citizens in CPR. Over the past decade there have been important advances in the science of resuscitation. Unfortunately, implementation of the scientific advances has lagged in many communities. This survey reinforces the need to provide more education about CPR including the teaching of hands-only CPR. It also highlights the need for communities to monitor their survival data and implement changes that can improve all aspects of the system of care that can result in improved survival from SCA."

Survey Findings

Conducted in September 2008, the State of Resuscitation survey suggests that almost all emergency physicians (94 percent) believe that a patient in sudden cardiac arrest is more likely to survive if a CPR-trained bystander administers CPR before professional rescuers arrive. In addition, more than half believe the length of time between patient collapse and first responder arrival is an important factor in determining the success of resuscitation efforts.

The survey also suggests that an overwhelming majority (89 percent) of emergency physicians feel that technology will play an increasingly important role in resuscitation over the next five years. Eighty-four percent note that emerging technologies/therapies are important in treating sudden cardiac arrest. Only one in four considers automated chest compression devices important, despite research that indicates their positive impact.

Other important findings include:

-- Approximately 3 out of 10 respondents say CPR feedback devices would
have the greatest impact on improving the quality of CPR.

-- More than half the respondents believe that poor survival rates from
sudden cardiac arrest is related to the aging population, while
one-quarter of respondents believe that obesity has contributed most
to poor survival rates.

-- Efforts to teach citizens CPR are scattered, and often, non-existent.
Not surprisingly, the respondents want civic leaders to be more
engaged in this issue.


The online survey was commissioned by ACEP and conducted by Saperstein Associates, Inc., an independent opinion research company. ZOLL Medical Corporation sponsored the survey. A total of 1,056 questionnaires were completed by ACEP members in selected membership sections. The study has a margin of error no greater than +/- 3.1 percentage points at the 95 percent level of confidence.

ACEP is a national medical specialty society representing emergency medicine with more than 27,000 members. ACEP is committed to advancing emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies.

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Team Teaches CPR to Afghan Medical Providers

Six Afghan medical providers learned basic lifesaving skills at a Panjshir Provincial Reconstruction Team cardiopulmonary resuscitation course held at the Rokha Clinic on June 18.

Air Force Staff Sgt. Janine Duschka, a PRT medical technician deployed from Andrews Air Force Base, Md., taught the course.

"It is important to teach the local medical providers, because it gives them another tool to save lives," Duschka said. "The tools they take home with them today are not ones they have to carry in their medical bags, and they're not something that they have to spend their money on. They're taking home knowledge that they can share with the rest of their staffs."

The medical providers were from six different clinics and four of the province's seven districts.

"This training is crucial, because most of the province's health care providers are in rural locations, so they need to be able to do [CPR] in order to get their critical patients to the hospital or to a better clinic," said Dr. Shirdell, Panjshir health and medical services officer.

The CPR class is the one-day American Heart Association course for health care providers authorized by the Military Training Network in Bethesda, Md. It covers not only CPR for patients of all ages, but also how to handle someone who is choking and the proper use of an automated external defibrillator unit.

The course also focuses on how to assess a patient to see if CPR is even necessary, and Duschka said she sees patient assessment as one of the main tools taught by the course.

"Now the medical providers know how to assess the signs the patient is giving instead of just reacting to a patient when they arrive," Duschka said. "Many of the Afghan medical providers I've dealt with in the past would have immediately started to give artificial breathing or CPR just because a patient's eyes were closed or they were unconscious, even if the patients were breathing normally already."

While some of the medical providers had learned prior forms of resuscitation, this course was new to most of them.

"They didn't have a preconceived notion of what CPR should be, since they've never taken any of the older CPR courses, so it was actually easier for me to teach them than it is teaching American students," Duschka said. "These providers all know how important this training is, and they all came ready to learn."

This is the first class out of a 15-class schedule, and I think it went very well and we all learned something from the class, Duschka said.

While Duschka taught her students the requirements from the course, they taught her some creative ways they've come up with to handle some of the trickier everyday medical situations.

For example, if a pregnant woman were choking, the providers said, they'd use a head-scarf to wrap around the woman if they couldn't reach their arms around her. Their solution uses an item that every Afghan woman keeps with her.

"Even though we're taught to use everything and anything that you have available to save the patient, using the scarf is an ingenious option that I never would have considered," Duschka said. "Although using the scarf is not a treatment of choice, the solution shows the providers clearly think outside of the box to help their patients in any way they can."

After spending the day teaching and learning from the local providers, Duschka was comfortable they would be able to provide better care to anyone who came into their clinics.

"If I came into their clinics, I know they could assess me, understand what was happening and treat me properly," she said. "Hopefully they won't ever have to use this course, but I'm happy to have been able to give the extra knowledge."

Shirdell agreed with Duschka.

"Whether they need to use [CPR] or not, they are learning that they always need to be in touch with the patient, and it is important to know what to do with a patient in any emergency situation," Shirdell said.

The PRT's CPR training program will continue throughout the year, and Duschka said she hopes to get out to different clinics in each of the province's seven districts.

Author Air Force Capt. Jillian Torango serves with the Panjshir Provincial Reconstruction Team Public Affairs Office