The Journal of the American Medical Association (JAMA) this week published significant findings in two studies noting improved patient outcomes for out-of-hospital cardiac arrest (OHCA) victims, influenced by bystander CPR interventions and the use of automated external defibrillators (AEDs).
The studies — “Association of Bystander and First-Responder Intervention with Survival After Out-of-Hospital Cardiac Arrest in North Carolina, 2010-2013” and “Association of Bystander Interventions with Neurologically Intact Survival Among Patients with Bystander-Witnessed Out-of-Hospital Cardiac Arrest in Japan” — appear in the July 21 issue of JAMA.
Many of the CPR techniques discussed, including Chest Compression-Only Resuscitation (COCPR), were developed at the University of Arizona College of Medicine – Tucson by UA Sarver Heart Center and UA emergency medicine physician-researchers.
The studies are accompanied by an editorial pointing out that outcomes following OHCA had not improved for more than 30 years in most communities until expanded training and the use of cardiopulmonary resuscitation (CPR) and AEDs by bystanders and first responders were introduced and accepted into common practice.
The issue also includes a guest viewpoint on an Institutes of Medicine report released June 30, “Strategies to Improve Cardiac Arrest Survival: A Time to Act,” in Washington, D.C., which includes as co-authors Arthur B. Sanders, MD, MHA, professor and a member of the University of Arizona Emergency Medicine Research Center – Tucson and the Institute of Medicine, and Bentley J. Bobrow, MD, FACEP, professor and co-director of the University of Arizona Emergency Medicine Research Center – Phoenix, and medical director of the Arizona Department of Health Services, Bureau of Emergency Medical Services and Trauma System.
They underscore that bystander CPR interventions in Arizona increased from 28 percent in 2005 to 40 percent in 2009 due to the state’s SHARE program, the first to train lay persons on COCPR. But only 40 percent of people suffering OHCA are resuscitated and brought alive to a hospital and, of those, one in four survive to go home. Dr. Bobrow notes sudden cardiac arrest survival rates with good neurologic function in most places are low. The JAMA editorial, however, indicates not only improved survival rates but similar improvements for favorable neurologic status of patients after hospital discharge in these most recent studies.
To continue to improve those favorable outcomes, the UA Sarver Heart Center Resuscitation Research Group has developed several free education resources for the general public and specific groups, such as teens and African Americans. This includes a training video featuring NBA Golden State Warriors basketball coach and former UA Wildcat Steve Kerr.
The Resuscitation Research Group, including Gordon Ewy, MD, and Karl Kern, MD, were pioneers in the efforts to improve survival and helped Arizona become a leader nationally in the approach to the treatment of patients suffering cardiac arrest. Dr. Kern, professor of medicine and UA Sarver Heart Center co-director, is the group’s principal investigator.
In addition, Daniel Spaite, MD, distinguished chair of emergency medicine and director of EMS Research Collaboration at the UA College of Medicine – Phoenix, has published several papers on related research, including the impact of public access defibrillator placement in metropolitan Phoenix.
For more background, please see “Check… Call… Compress in Cases of Sudden Cardiac Arrest” or visit the UA Sarver Heart Center at http://heart.arizona.edu.