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Improving the Quality of Cardiac Arrest Resuscitation Care

  • C. J. Dine
  • B. S. Abella
Conference paper

Abstract

Sudden cardiac arrest is defined as the cessation of mechanical cardiac activity as confirmed by the absence of signs of circulation [1]. Sudden cardiac arrest is one of the leading causes of mortality in the hospital as well as in the community setting. There are similar rates of sudden cardiac arrest in North America and Europe, leading to over 700,000 deaths in both regions combined annually [2, 3, 4] and, although overall cardiovascular mortality is decreasing, the proportion of deaths from sudden cardiac arrest has remained constant with a high mortality rate [5]. In fact, the survival rate from out-of-hospital sudden cardiac arrest has been reported to vary between 5 to 18%, depending on the original arrest rhythm and other factors [6].

Keywords

Cardiac Arrest Chest Compression Sudden Cardiac Arrest Coronary Perfusion Pressure Automate External Defibrillator 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Eisenberg MS, Mengert TJ (2001) Cardiac resuscitation. N Engl J Med 344:1304–1313PubMedCrossRefGoogle Scholar
  2. 2.
    Zipes DP, Wellens HJ (1998) Sudden cardiac death. Circulation 98:2334–2351PubMedGoogle Scholar
  3. 3.
    Myerburg RJ, Kessler KM, Castellanos A (1993) Sudden cardiac death epidemiology, transient risk, and intervention assessment. Ann Intern Med 119:1187–1197PubMedGoogle Scholar
  4. 4.
    Priori SG, Aliot E, Blomstrom-Lundqvist C, et al (2001) Task Force on Sudden Cardiac Death of the European Society of Cardiology. Eur Heart J 22:1374–1450PubMedCrossRefGoogle Scholar
  5. 5.
    Myerburg RJ, Interian A Jr, Mitrani RM, Kessler KM, Castellanos A (1997) Frequency of sudden cardiac death and profiles of risk. Am J Cardiol 80:10F–19FPubMedCrossRefGoogle Scholar
  6. 6.
    Ali B, Zafari, AM (2007) Narrative review: Cardiopulmonary resuscitation and emergency cardiovascular care: Review of the current guidelines. JAMA 147:171–179Google Scholar
  7. 7.
    Van Hoeyweghen RJ, Bossert LL, Mullie A, et al (1993) Quality and efficiency of bystander CPR. Belgian Cerebral Resuscitation Study Group. Resuscitation 26: 47–52PubMedCrossRefGoogle Scholar
  8. 8.
    Gallagher EJ, Lombardi G, Gennis P (1995) Effectiveness of bystander cardiopulmonary resuscitation and survival following out-of-hospital arrest. JAMA 274:1922–1925PubMedCrossRefGoogle Scholar
  9. 9.
    Berg RA, Sanders AB, Kern KB, et al (2001) Adverse hemodynamic effects of interrupting chest compressions for rescue breathing during cardiopulmonary resuscitation for ventricular fibrillation cardiac arrest. Circulation 104: 2465–2470PubMedCrossRefGoogle Scholar
  10. 10.
    Dowie R, Campbell H, Donohoe R, Clarke P (2003) “Event tree” analysis of out-of-hospital cardiac arrest data: confirming the importance of bystander CPR. Resuscitation 56:173–181PubMedCrossRefGoogle Scholar
  11. 11.
    Abella BS, Alvarado JP, Myklebust H, et al (2005) Quality of cardiopulmonary resuscitation during in-hospital cardiac arrest. JAMA 293:305–310PubMedCrossRefGoogle Scholar
  12. 12.
    Olasveengen TM, Wik L, Steen PA (2007) Quality of cardiopulmonary resuscitation before and during transport in out-of-hospital cardiac arrest. Resuscitation [epub ahead of print]Google Scholar
  13. 13.
    ECC Committee, Subcommittee and Task Forces of the American Heart Association (2005) 2005 American Heart Association Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 112(24 suppl):IVl–203Google Scholar
  14. 14.
    So HY, Buckley TA, Oh TE (1994) Factors affecting outcome following cardiopulmonary resuscitation. Anaesth Intensive Care 22:647–658PubMedGoogle Scholar
  15. 15.
    Mitchell RG, Brady W, Guly UM, Pirrallo RG, Robertson CE (1997) Comparison of two emergency response systems and their effect on survival from out of hospital cardiac arrest. Resuscitation 35:225–229PubMedCrossRefGoogle Scholar
  16. 16.
    Cheung S, Deakin CD, Hsu R, Petley GW, Clewlow F (2007) A prospective manikin-based observational study of telephone cardiopulmonary resuscitation. Resuscitation 72:425–435PubMedCrossRefGoogle Scholar
  17. 17.
    Deakin CD, Cheung S, Petley GW, Clewlow F (2007) Assessment of the quality of cardiopulmonary resuscitation following modification of a standard telephone-directed protocol. Resuscitation 72:436–334PubMedCrossRefGoogle Scholar
  18. 18.
    Shibata K, Taniguchi T, Yoshida M, Yamamoto K (2000) Obstacles to bystander cardiopulmonary resuscitation in Japan. Resuscitation 44:187–193PubMedCrossRefGoogle Scholar
  19. 19.
    Berg RA, Kern KB, Sanders AB, Otto CW, Hilwig RW, Ewy GA (1993) Bystander cardiopulmonary resuscitation. Is ventilation necessary? Circulation 88:1907–1915PubMedGoogle Scholar
  20. 20.
    Babbs CF, Kern KB (2002) Optimum compression to ventilation ratios in CPR under realistic, practical conditions: a physiological and mathematical analysis. Resuscitation 54:147–157PubMedCrossRefGoogle Scholar
  21. 21.
    Sanders AB, Kern KB, Berg RA, Hilwig RW, Heidenrich J, Ewy GA (2002) Survival and neurologic outcome after cardiopulmonary resuscitation with four different chest compressionventilation ratios. Ann Emerg Med 40:553–562PubMedCrossRefGoogle Scholar
  22. 22.
    Heidenreich JW, Sanders AB, Higdon TA, Kern KB, Berg RA, Ewy GA (2004) Uninterrupted chest compression CPR is easier to perform and remember than standard CPR. Resuscitation 63:123–130PubMedCrossRefGoogle Scholar
  23. 23.
    Yannopoulos D, Sigurdsson G, McKnite S, Benditt D, Lurie KG (2004) Reducing ventilation frequency combined with an inspiratory impedance device improves CPR efficiency in swine model of cardiac arrest. Resuscitation 61:75–82PubMedCrossRefGoogle Scholar
  24. 24.
    SOS-KANTO study group (2007) Cardiopulmonary resuscitation by bystanders with chest compression only (SOS-KANTO): an observational study. Lancet 369:920–926CrossRefGoogle Scholar
  25. 25.
    Williamson LJ, Larsen PD, Tzeng YC, Galletly DC (2005) Effect of automatic external defibrillator audio prompts on cardiopulmonary resuscitation performance. Emerg Med J 22:140–143PubMedCrossRefGoogle Scholar
  26. 26.
    Wik L, Thowsen J, Steen PA (2001) An automated voice advisory manikin system for training in basic life support without an instructor. A novel approach to CPR training. Resuscitation 50:167–172PubMedCrossRefGoogle Scholar
  27. 27.
    Handley AJ, Handley SA (2003) Improving CPR performance using an audible feedback system suitable for incorporation into an automated external defibrillator. Resuscitation 57: 57–62PubMedCrossRefGoogle Scholar
  28. 28.
    Abella BS, Edelson DP, Kim S, et al (2007) CPR quality improvement using in-hospital cardiac arrest using a real time audiovisual feedback system. Resuscitation 73:54–61PubMedCrossRefGoogle Scholar
  29. 29.
    Lurie KG, Zielinski T, McKnite S, Aufderheide TP, Voelckel W (2002) Use of an inspiratory impedance valve improves neurologically intact survival in a porcine model of ventricular fibrillation. Circulation 105:124–129PubMedCrossRefGoogle Scholar
  30. 30.
    Pirrallo RG, Aufderheide TP, Provo TA, Lurie KG (2005) Effect of an inspiratory impedance threshold device on hemodynamics during conventional manual cardiopulmonary resuscitation. Resuscitation 66:13–20PubMedCrossRefGoogle Scholar
  31. 31.
    Aufderheide TP, Pirrallo RG, Provo TA, Lurie KG (2005) Clinical evaluation of an inspiratory impedance threshold device during standard cardiopulmonary resuscitation in patients with out-of-hospital cardiac arrest. Crit Care Med 33:734–740PubMedCrossRefGoogle Scholar
  32. 32.
    Ong ME, Ornato JP, Edwards DP, et al (2006) Use of an automated, load-distributing band chest compression device for out-of-hospital cardiac arrest resuscitation. JAMA 295:2629–2637PubMedCrossRefGoogle Scholar
  33. 33.
    Hallstrom A, Rea TD, Sayre MR, et al (2006) Manual chest compression vs use of an automated chest compression device during resuscitation following out-of-hospital cardiac arrest: a randomized trial. JAMA 295:2661–2664CrossRefGoogle Scholar
  34. 34.
    Steen S, Sjöberg T, Olsson P, Young M (2005) Treatment of out-of-hospital cardiac arrest with LUCAS, a new device for automatic mechanical compressions and active decompression resuscitation. Resuscitation 67:25–30PubMedCrossRefGoogle Scholar
  35. 35.
    Hayes CW, Rhee A, Detsky ME, Leblanc VR, Wax RS (2007) Residents feel unprepared and unsupervised as leaders of cardiac arrest teams in teaching hospitals: a survey of internal medicine residents. Crit Care Med 35:1668–1672PubMedCrossRefGoogle Scholar
  36. 36.
    Perkins GD (2007) Simulation in resuscitation training. Resuscitation 73:202–211PubMedCrossRefGoogle Scholar
  37. 37.
    Nolan JP (2001) Advanced life support training. Resuscitation 50:9–11PubMedCrossRefGoogle Scholar
  38. 38.
    Wayne DB, Butter J, Siddal VJ, et al (2005) Simulation-based training of internal medicine residents in advanced cardiac life support protocols: A randomized trial. Teach Learn Med 17:202–208PubMedCrossRefGoogle Scholar
  39. 39.
    Marsch SC, Müller C, Marquardt K, Conrad G, Tschan F, Hunziker PR (2004) Human factors affect the quality of cardiopulmonary resuscitation in simulated cardiac arrests. Resuscitation 60:51–56PubMedCrossRefGoogle Scholar
  40. 40.
    Edelson DP, Litzinger B, Arora V, et al (2007) Resuscitation with actual performance integrated debriefing (rapid) improves trainee cpr quality and initial patient survival. Arch Intern Med (in press)Google Scholar
  41. 41.
    Lottes AE, Rundell AE, Geddes LA, Kemeny AE, Otlewski MP, Babbs CF (2007) Sustained abdominal compression during CPR raises coronary perfusion pressures as much as vasopressor drugs. Resuscitation 75:515–524PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media Inc. 2008

Authors and Affiliations

  • C. J. Dine
    • 1
  • B. S. Abella
    • 2
  1. 1.Division of Pulmonary, AllergyCritical Care University of PennsylvaniaPhiladelphiaUSA
  2. 2.Department of Emergency MedicineUniversity of PennsylvaniaPhiladelphiaUSA

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