Implementing the 2005 American Heart Association Guidelines improves outcomes after out-of-hospital cardiac arrest

Tom P. Aufderheide, Demetris Yannopoulos, Charles J. Lick, Brent Myers, Laurie A. Romig, Joseph C. Stothert, Jeffrey Barnard, Levon Vartanian, Ashley J. Pilgrim, David G. Benditt

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

Objective: The purpose of the study was to determine whether applying highly recommended changes in the 2005 American Heart Association (AHA) Guidelines would improve outcomes after out-of-hospital cardiac arrest. Background: In 2005, AHA recommended multiple ways to improve circulation during cardiopulmonary resuscitation (CPR). Methods: Conglomerate quality assurance data were analyzed during prospective implementation of the 2005 AHA Guidelines in five emergency medical services (EMS) systems. All EMS personnel were trained in the key new aspects of the 2005 AHA Guidelines, including use of an impedance threshold device. The primary outcome was survival to hospital discharge. Secondary outcomes were return of spontaneous circulation (ROSC), survival by initial cardiac arrest rhythm, and the cerebral performance category (CPC) score at hospital discharge. Results: There were 1,605 patients in the intervention group and 1,641 patients in the control group. Demographics, the rate of bystander CPR, and time from the 911 call for help to arrival of EMS personnel were similar between groups. Survival to hospital discharge was 10.1% in the control group versus 13.1% in the intervention group (P = .007). For patients with a presenting rhythm of ventricular fibrillation/ventricular tachycardia, survival to discharge was 20% in controls versus 32.3% in the intervention group (P <.001). Survival to discharge with a CPC classification of 1 or 2 was 33.3% (10/30) in the control versus 59.6% (31/52) in the intervention group (P = .038). Conclusions: Compared with controls, patients with out-of-hospital cardiac arrest treated with a renewed emphasis on improved circulation during CPR had significantly higher neurologically intact hospital discharge rates.

Original languageEnglish (US)
Pages (from-to)1357-1362
Number of pages6
JournalHeart Rhythm
Volume7
Issue number10
DOIs
StatePublished - Oct 1 2010

Fingerprint

Out-of-Hospital Cardiac Arrest
American Heart Association
Guidelines
Cardiopulmonary Resuscitation
Emergency Medical Services
Survival
Control Groups
Ventricular Fibrillation
Ventricular Tachycardia
Heart Arrest
Electric Impedance
Demography
Equipment and Supplies

Keywords

  • CPR
  • Cardiac arrest
  • Impedance threshold device
  • Sudden death
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Aufderheide, T. P., Yannopoulos, D., Lick, C. J., Myers, B., Romig, L. A., Stothert, J. C., ... Benditt, D. G. (2010). Implementing the 2005 American Heart Association Guidelines improves outcomes after out-of-hospital cardiac arrest. Heart Rhythm, 7(10), 1357-1362. https://doi.org/10.1016/j.hrthm.2010.04.022

Implementing the 2005 American Heart Association Guidelines improves outcomes after out-of-hospital cardiac arrest. / Aufderheide, Tom P.; Yannopoulos, Demetris; Lick, Charles J.; Myers, Brent; Romig, Laurie A.; Stothert, Joseph C.; Barnard, Jeffrey; Vartanian, Levon; Pilgrim, Ashley J.; Benditt, David G.

In: Heart Rhythm, Vol. 7, No. 10, 01.10.2010, p. 1357-1362.

Research output: Contribution to journalArticle

Aufderheide, TP, Yannopoulos, D, Lick, CJ, Myers, B, Romig, LA, Stothert, JC, Barnard, J, Vartanian, L, Pilgrim, AJ & Benditt, DG 2010, 'Implementing the 2005 American Heart Association Guidelines improves outcomes after out-of-hospital cardiac arrest', Heart Rhythm, vol. 7, no. 10, pp. 1357-1362. https://doi.org/10.1016/j.hrthm.2010.04.022
Aufderheide, Tom P. ; Yannopoulos, Demetris ; Lick, Charles J. ; Myers, Brent ; Romig, Laurie A. ; Stothert, Joseph C. ; Barnard, Jeffrey ; Vartanian, Levon ; Pilgrim, Ashley J. ; Benditt, David G. / Implementing the 2005 American Heart Association Guidelines improves outcomes after out-of-hospital cardiac arrest. In: Heart Rhythm. 2010 ; Vol. 7, No. 10. pp. 1357-1362.
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abstract = "Objective: The purpose of the study was to determine whether applying highly recommended changes in the 2005 American Heart Association (AHA) Guidelines would improve outcomes after out-of-hospital cardiac arrest. Background: In 2005, AHA recommended multiple ways to improve circulation during cardiopulmonary resuscitation (CPR). Methods: Conglomerate quality assurance data were analyzed during prospective implementation of the 2005 AHA Guidelines in five emergency medical services (EMS) systems. All EMS personnel were trained in the key new aspects of the 2005 AHA Guidelines, including use of an impedance threshold device. The primary outcome was survival to hospital discharge. Secondary outcomes were return of spontaneous circulation (ROSC), survival by initial cardiac arrest rhythm, and the cerebral performance category (CPC) score at hospital discharge. Results: There were 1,605 patients in the intervention group and 1,641 patients in the control group. Demographics, the rate of bystander CPR, and time from the 911 call for help to arrival of EMS personnel were similar between groups. Survival to hospital discharge was 10.1{\%} in the control group versus 13.1{\%} in the intervention group (P = .007). For patients with a presenting rhythm of ventricular fibrillation/ventricular tachycardia, survival to discharge was 20{\%} in controls versus 32.3{\%} in the intervention group (P <.001). Survival to discharge with a CPC classification of 1 or 2 was 33.3{\%} (10/30) in the control versus 59.6{\%} (31/52) in the intervention group (P = .038). Conclusions: Compared with controls, patients with out-of-hospital cardiac arrest treated with a renewed emphasis on improved circulation during CPR had significantly higher neurologically intact hospital discharge rates.",
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AU - Lick, Charles J.

AU - Myers, Brent

AU - Romig, Laurie A.

AU - Stothert, Joseph C.

AU - Barnard, Jeffrey

AU - Vartanian, Levon

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AU - Benditt, David G.

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N2 - Objective: The purpose of the study was to determine whether applying highly recommended changes in the 2005 American Heart Association (AHA) Guidelines would improve outcomes after out-of-hospital cardiac arrest. Background: In 2005, AHA recommended multiple ways to improve circulation during cardiopulmonary resuscitation (CPR). Methods: Conglomerate quality assurance data were analyzed during prospective implementation of the 2005 AHA Guidelines in five emergency medical services (EMS) systems. All EMS personnel were trained in the key new aspects of the 2005 AHA Guidelines, including use of an impedance threshold device. The primary outcome was survival to hospital discharge. Secondary outcomes were return of spontaneous circulation (ROSC), survival by initial cardiac arrest rhythm, and the cerebral performance category (CPC) score at hospital discharge. Results: There were 1,605 patients in the intervention group and 1,641 patients in the control group. Demographics, the rate of bystander CPR, and time from the 911 call for help to arrival of EMS personnel were similar between groups. Survival to hospital discharge was 10.1% in the control group versus 13.1% in the intervention group (P = .007). For patients with a presenting rhythm of ventricular fibrillation/ventricular tachycardia, survival to discharge was 20% in controls versus 32.3% in the intervention group (P <.001). Survival to discharge with a CPC classification of 1 or 2 was 33.3% (10/30) in the control versus 59.6% (31/52) in the intervention group (P = .038). Conclusions: Compared with controls, patients with out-of-hospital cardiac arrest treated with a renewed emphasis on improved circulation during CPR had significantly higher neurologically intact hospital discharge rates.

AB - Objective: The purpose of the study was to determine whether applying highly recommended changes in the 2005 American Heart Association (AHA) Guidelines would improve outcomes after out-of-hospital cardiac arrest. Background: In 2005, AHA recommended multiple ways to improve circulation during cardiopulmonary resuscitation (CPR). Methods: Conglomerate quality assurance data were analyzed during prospective implementation of the 2005 AHA Guidelines in five emergency medical services (EMS) systems. All EMS personnel were trained in the key new aspects of the 2005 AHA Guidelines, including use of an impedance threshold device. The primary outcome was survival to hospital discharge. Secondary outcomes were return of spontaneous circulation (ROSC), survival by initial cardiac arrest rhythm, and the cerebral performance category (CPC) score at hospital discharge. Results: There were 1,605 patients in the intervention group and 1,641 patients in the control group. Demographics, the rate of bystander CPR, and time from the 911 call for help to arrival of EMS personnel were similar between groups. Survival to hospital discharge was 10.1% in the control group versus 13.1% in the intervention group (P = .007). For patients with a presenting rhythm of ventricular fibrillation/ventricular tachycardia, survival to discharge was 20% in controls versus 32.3% in the intervention group (P <.001). Survival to discharge with a CPC classification of 1 or 2 was 33.3% (10/30) in the control versus 59.6% (31/52) in the intervention group (P = .038). Conclusions: Compared with controls, patients with out-of-hospital cardiac arrest treated with a renewed emphasis on improved circulation during CPR had significantly higher neurologically intact hospital discharge rates.

KW - CPR

KW - Cardiac arrest

KW - Impedance threshold device

KW - Sudden death

KW - Ventricular fibrillation

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