SOPs and the right hospitals to improve outcome after cardiac arrest.
Approximately 400,000 Europeans are yearly resuscitated from out-of-hospital cardiac arrest (OHCA).(1,2) Despite evolving evidence based guidelines for cardiopulmonary resuscitation (CPR), survival rates after OHCA has not improved much in several places around the world. However, a potential for improved survival is absolutely present, based on the huge spread in worldwide survival; some cities with survival over 20-30% and some cities with just a few percent.(1,2) These survival differences can partly be explained by different definitions of OHCA,(2) but mainly due to the overall quality of the local Chain of Survival (COS)(3); early arrest recognition and call for help, early CPR, early defibrillation and early post resuscitation care. By identifying and thereafter improving weak links in the local COS, survival can indeed increase. This review will focus on the quality of the last link in the COS, the hospital treatment after return of spontaneuous circulation (ROSC), and how good quality post resuscitation care can improve not only survival, but survival with neurologically intact outcome.
Department of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital Ulleval, Kirkeveien 166, 0407 Oslo, Norway. Electronic address: kjetil.sunde@medisin.uio.no.
Kjetil
K
Sunde
D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004554:Electric Countershock / Q000379:methods; D005060:Europe; D019317:Evidence-Based Medicine / Q000379:methods; D006761:Hospitals / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
cardiac arrest; outcome; post resuscitation care; therapeutic hypothermia