Improving outcome in out-of-hospital cardiac arrest: impact of bystander cardiopulmonary resuscitation and prehospital physician care.
Evidence for the impact of prehospital, physician-delivered advanced cardiac life support (ACLS) on survival from out-of-hospital cardiac arrest is conflicting. The prospective observational study by Yasunaga and co-workers demonstrates an improved survival at 1 month associated with prehospital physician-delivered ACLS over emergency life-saving technician-delivered ACLS. These effects are additive to the survival benefit seen with bystander-initiated cardiopulmonary resuscitation (BCPR) compared with no BCPR. The present commentary places these findings in the context of the existing literature and discusses some of the unresolved controversies.
Intensive Care Medicine, Royal United Hospital NHS Trust, Bath BA1 3NG, UK. robsjournals@randkjackson.co.uk
Robert J H
RJ
Jackson
Jerry P
JP
Nolan
D022561:Advanced Cardiac Life Support / Q000401:mortality*; D016887:Cardiopulmonary Resuscitation / Q000401:mortality*; D003299:Cooperative Behavior; D005260:Female; D006801:Humans; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality* / Q000628:therapy*; D010820:Physicians; D011159:Population Surveillance
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