Review article

Regional cardiac resuscitation systems of care

Nichol Graham ; Medic One Foundation, Harborview Center for Prehospital Emergency Care, Medical Director, University of Washington Clinical Trials Center, Division of General Internal Medicine, Harborview Medical Center, 325 Ninth Avenue, Box 359727, Seattle, Washington

Abstract

Out-of-hospital cardiac arrest (OOHCA) is a common public health problem, with large and important regional variations
in outcomes. Survival rates vary widely among patients treated with OOHCA by emergency medical services (EMS), or
among patients transported to the hospital after return of spontaneous circulation. Most regions lack a well-coordinated
approach to post–cardiac arrest care. Effective hospital-based interventions for OOHCA exist but are used infrequently.
Increased volume of patients or procedures of individual providers and hospitals is associated with better outcomes for
several other clinical disorders. Regional systems of cardiac resuscitation include a process for identification of patients
with OOHCA, standard field and hospital care protocols for patients with OOHCA, monitoring of care processes and outcome,
and periodic review and feedback of these quality improvement data to identify problems and implement solutions.
Similar systems have improved provider experience and patient outcomes for those with ST-elevation myocardial infarction
and life-threatening traumatic injury. Many more people could survive OOHCA if regional systems of cardiac resuscitation
were implemented and maintained. The time has come to do so wherever feasible.

Keywords

out-of-hospital cardiac arrest; emergency medical services; hospital-based interventions; regional systems of cardiopulmonary resuscitation (CPR); monitoring; outcome; transport time; improve of quality; survival

Hrčak ID:

59438

URI

https://hrcak.srce.hr/59438

Publication date:

1.9.2010.

Visits: 1.322 *