title: An alternative approach to advancing resuscitation science.
abstract: Stagnant survival rates in out-of-hospital cardiac arrest remain a great impetus for advancing resuscitation science. International resuscitation guidelines, with all their advantages for standardizing resuscitation therapeutic protocols, can be difficult to change. A formalized evidence-based process has been adopted by the International Liason Committee on Resuscitation (ILCOR) in formulating such guidelines. Currently, randomized clinical trials are considered optimal evidence, and very few major changes in the Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care are made without such. An alternative approach is to allow externally controlled clinical trials more weight in Guideline formulation and resuscitation protocol adoption. In Tucson, Arizona (USA), the Fire Department cardiac arrest database has revealed a number of resuscitation issues. These include a poor bystander CPR rate, a lack of response to initial defibrillation after prolonged ventricular fibrillation, and substantial time without chest compressions during the resuscitation effort. A local change in our previous resuscitation protocols had been instituted based upon this historical database information.
authors.affiliation: College of Medicine, Sarver Heart Center, University of Arizona, 1501 N. Campbell Avenue, Tucson, AZ 85724, USA. kernk@u.arizona.edu
authors.forename: Karl B
authors.initials: KB
authors.lastname: Kern
authors.forename: Terence D
authors.initials: TD
authors.lastname: Valenzuela
authors.forename: Lani L
authors.initials: LL
authors.lastname: Clark
authors.forename: Robert A
authors.initials: RA
authors.lastname: Berg
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Hilwig
authors.forename: Marc D
authors.initials: MD
authors.lastname: Berg
authors.forename: Charles W
authors.initials: CW
authors.lastname: Otto
authors.forename: Daniel
authors.initials: D
authors.lastname: Newburn
authors.forename: Gordon A
authors.initials: GA
authors.lastname: Ewy
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D002986:Clinical Trials as Topic; D004554:Electric Countershock; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D017410:Practice Guidelines as Topic