The Cardiocerebral Resuscitation protocol for treatment of out-of-hospital primary cardiac arrest
<p>Abstract</p> <p>Out-of-hospital cardiac arrest (OHCA) is a significant public health problem in most westernized industrialized nations. In spite of national and international guidelines for cardiopulmonary resuscitation and emergency cardiac care, the overall survival of patien...
| Main Author: | |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2012-09-01
|
| Series: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| Subjects: | |
| Online Access: | http://www.sjtrem.com/content/20/1/65 |
| _version_ | 1818789062821019648 |
|---|---|
| author | Ewy Gordon A |
| author_facet | Ewy Gordon A |
| author_sort | Ewy Gordon A |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Out-of-hospital cardiac arrest (OHCA) is a significant public health problem in most westernized industrialized nations. In spite of national and international guidelines for cardiopulmonary resuscitation and emergency cardiac care, the overall survival of patients with OHCA was essentially unchanged for 30 years--from 1978 to 2008 at 7.6%. Perhaps a better indicator of Emergency Medical System (EMS) effectiveness in treating patients with OHCA is to focus on the subgroup that has a reasonable chance of survival, e.g., patients found to be in ventricular fibrillation (VF). But even in this subgroup, the average survival rate was 17.7% in the United States, unchanged between 1980 and 2003, and 21% in Europe, unchanged between 1980 and 2004. Prior to 2003, the survival of patients with OHCA, in VF in Tucson, Arizona was less than 9% in spite of incorporating previous guideline recommendations. An alternative (non-guidelines) approach to the therapy of patients with OHCA and a shockable rhythm, called Cardiocerebral Resuscitation, based on our extensive physiologic laboratory studies, was introduced in Tucson in 2003, in rural Wisconsin in 2004, and in selected EMS areas in the metropolitan Phoenix area in 2005. Survival of patients with OHCA due to VF treated with Cardiocerebral Resuscitation in rural Wisconsin increased to 38% and in 60 EMS systems in Arizona to 39%. In 2004, we began a statewide program to advocate chest compression-only CPR for bystanders of witnessed primary OHCA. Over the next five years, we found that survival of patients with a shockable rhythm was 17.7% in those treated with standard bystander CPR (mouth-to-mouth ventilations plus chest compression) compared to 33.7% for those who received bystander chest-compression-only CPR. This article on Cardiocerebral Resuscitation, by invitation following a presentation at the 2011 Danish Society Emergency Medical Conference, summarizes the results of therapy of patients with primary OHCA treated with Cardiocerebral Resuscitation, with requested emphasis on the EMS protocol.</p> |
| first_indexed | 2024-12-18T14:33:36Z |
| format | Article |
| id | doaj.art-6846726db4b24f14b3e2302b7a7d608c |
| institution | Directory Open Access Journal |
| issn | 1757-7241 |
| language | English |
| last_indexed | 2024-12-18T14:33:36Z |
| publishDate | 2012-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| spelling | doaj.art-6846726db4b24f14b3e2302b7a7d608c2022-12-21T21:04:32ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412012-09-012016510.1186/1757-7241-20-65The Cardiocerebral Resuscitation protocol for treatment of out-of-hospital primary cardiac arrestEwy Gordon A<p>Abstract</p> <p>Out-of-hospital cardiac arrest (OHCA) is a significant public health problem in most westernized industrialized nations. In spite of national and international guidelines for cardiopulmonary resuscitation and emergency cardiac care, the overall survival of patients with OHCA was essentially unchanged for 30 years--from 1978 to 2008 at 7.6%. Perhaps a better indicator of Emergency Medical System (EMS) effectiveness in treating patients with OHCA is to focus on the subgroup that has a reasonable chance of survival, e.g., patients found to be in ventricular fibrillation (VF). But even in this subgroup, the average survival rate was 17.7% in the United States, unchanged between 1980 and 2003, and 21% in Europe, unchanged between 1980 and 2004. Prior to 2003, the survival of patients with OHCA, in VF in Tucson, Arizona was less than 9% in spite of incorporating previous guideline recommendations. An alternative (non-guidelines) approach to the therapy of patients with OHCA and a shockable rhythm, called Cardiocerebral Resuscitation, based on our extensive physiologic laboratory studies, was introduced in Tucson in 2003, in rural Wisconsin in 2004, and in selected EMS areas in the metropolitan Phoenix area in 2005. Survival of patients with OHCA due to VF treated with Cardiocerebral Resuscitation in rural Wisconsin increased to 38% and in 60 EMS systems in Arizona to 39%. In 2004, we began a statewide program to advocate chest compression-only CPR for bystanders of witnessed primary OHCA. Over the next five years, we found that survival of patients with a shockable rhythm was 17.7% in those treated with standard bystander CPR (mouth-to-mouth ventilations plus chest compression) compared to 33.7% for those who received bystander chest-compression-only CPR. This article on Cardiocerebral Resuscitation, by invitation following a presentation at the 2011 Danish Society Emergency Medical Conference, summarizes the results of therapy of patients with primary OHCA treated with Cardiocerebral Resuscitation, with requested emphasis on the EMS protocol.</p>http://www.sjtrem.com/content/20/1/65Ventricular fibrillationResuscitationCardiac arrestCardiopulmonary resuscitationCardiocerebral resuscitationPrimary cardiac arrestEmergency medical systemOut-of-hospital cardiac arrest |
| spellingShingle | Ewy Gordon A The Cardiocerebral Resuscitation protocol for treatment of out-of-hospital primary cardiac arrest Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Ventricular fibrillation Resuscitation Cardiac arrest Cardiopulmonary resuscitation Cardiocerebral resuscitation Primary cardiac arrest Emergency medical system Out-of-hospital cardiac arrest |
| title | The Cardiocerebral Resuscitation protocol for treatment of out-of-hospital primary cardiac arrest |
| title_full | The Cardiocerebral Resuscitation protocol for treatment of out-of-hospital primary cardiac arrest |
| title_fullStr | The Cardiocerebral Resuscitation protocol for treatment of out-of-hospital primary cardiac arrest |
| title_full_unstemmed | The Cardiocerebral Resuscitation protocol for treatment of out-of-hospital primary cardiac arrest |
| title_short | The Cardiocerebral Resuscitation protocol for treatment of out-of-hospital primary cardiac arrest |
| title_sort | cardiocerebral resuscitation protocol for treatment of out of hospital primary cardiac arrest |
| topic | Ventricular fibrillation Resuscitation Cardiac arrest Cardiopulmonary resuscitation Cardiocerebral resuscitation Primary cardiac arrest Emergency medical system Out-of-hospital cardiac arrest |
| url | http://www.sjtrem.com/content/20/1/65 |
| work_keys_str_mv | AT ewygordona thecardiocerebralresuscitationprotocolfortreatmentofoutofhospitalprimarycardiacarrest AT ewygordona cardiocerebralresuscitationprotocolfortreatmentofoutofhospitalprimarycardiacarrest |