title: The efficacy of an ACLS training program for resuscitation from cardiac arrest in a rural community.
abstract: OBJECTIVE
  To determine whether an advanced cardiac life support (ACLS) course in a rural hospital will improve resuscitation success from cardiac arrest.
  
  
  METHODS
  A retrospective case review of all patients in cardiac arrest during a 13-month period before and after the institution of an ACLS training program.
  
  
  METHODS
  Emergency department of a 42-bed rural, community hospital in a community with no prehospital advanced life support or early defibrillation.
  
  
  METHODS
  All patients in cardiac arrest were entered into the data base. Twenty-nine patients were included in the pre-ACLS period and 35 in the post-ACLS period. There were no significant differences in age, gender, initial rhythm, comorbid diseases, witnessed versus unwitnessed arrest, or total arrest time in the patients in the pre-ACLS period compared with those in the post-ACLS period.
  
  
  METHODS
  ACLS provider training.
  
  
  RESULTS
  Patients in cardiac arrest who had ventricular fibrillation/tachycardia as their initial rhythm had significant improvement in resuscitation success compared with patients in ventricular fibrillation/tachycardia in the pre-ACLS period (six of 15 versus none of nine, P < .05). Out-of-hospital cardiac arrest resuscitation was more successful in the post-ACLS period than in the pre-ACLS period (five of 30 versus none of 25, P < .05). Overall, seven of 35 patients (20%) were resuscitated successfully in the post-ACLS period, with two patients surviving to hospital discharge. This was not significantly different than the two of 29 patients (7%) resuscitated in the pre-ACLS period, with one patient surviving to discharge.
  
  
  CONCLUSIONS
  The institution of an ACLS-provider course in a rural community hospital was associated with improvement in initial resuscitation for patients with ventricular fibrillation/tachycardia and out-of-hospital arrest.
authors.affiliation: Department of Surgery, University of Arizona College of Medicine.
authors.forename: A B
authors.initials: AB
authors.lastname: Sanders
authors.forename: R A
authors.initials: RA
authors.lastname: Berg
authors.forename: M
authors.initials: M
authors.lastname: Burress
authors.forename: R T
authors.initials: RT
authors.lastname: Genova
authors.forename: K B
authors.initials: KB
authors.lastname: Kern
authors.forename: G A
authors.initials: GA
authors.lastname: Ewy
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000193:education*; D005069:Evaluation Studies as Topic; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006743:Hospital Bed Capacity, under 100; D006764:Hospitals, Community; D006780:Hospitals, Rural; D006801:Humans; D007318:Inservice Training; D008297:Male; D012189:Retrospective Studies; D014481:United States; D000078329:Workforce