Improving the outcome of in-hospital cardiac arrest: the importance of being EARNEST.
Cardiopulmonary resuscitation techniques were introduced more than 50 years ago, yet the rate of survival from cardiac arrest, particularly in the hospital setting, remains dismally low. This article reviews the prevalence, etiology, and outcome of in-hospital cardiac arrest, with a focus on the determinants of outcome that are amenable to improvement. These include principally components of basic life support that may be supported by either prompting or mechanical assistance (eg, chest compression, ventilation, and defibrillation). Also reviewed are preevent and postevent effectors such as medical staff skills and recognition of impending arrest, induction of mild hypothermia, and stabilization after return of spontaneous circulation.
Dichtwald
Sara
S
Department of Anesthesiology and Critical Care Medicine, Sourasky Medical Center affiliated with the Tel Aviv University, Tel Aviv, Israel.
Matot
Idit
I
Einav
Sharon
S
D001775:Blood Circulation / Q000502:physiology; D016887:Cardiopulmonary Resuscitation; D002983:Clinical Competence; D002985:Clinical Protocols; D004554:Electric Countershock; D004700:Endocrine System Diseases / Q000209:etiology / Q000628:therapy; D006323:Heart Arrest / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D017052:Hospital Mortality; D006801:Humans; D007036:Hypothermia, Induced; D008021:Life Support Systems; D010348:Patient Care Team; D012121:Respiration, Artificial; D016896:Treatment Outcome