Systems Approach Improves Survival from Cardiac Arrest

During 2006–2008, one quarter of patients with out-of-hospital cardiac arrest survived to discharge in one region of Norway.


As part of ongoing global efforts to monitor and improve survival from cardiac arrest, investigators prospectively compared survival rates for out-of-hospital cardiac arrest (OHCA) during 2001–2005 and 2006–2008 in a region of Norway. The study included 846 adult patients with OHCA of presumed cardiac etiology in whom resuscitation was attempted by emergency medical services (EMS).

In the first period, the local resuscitation algorithm was similar to the 2000 European Resuscitation Council guidelines, whereas in the second period, the algorithm differed from the 2005 guidelines in that it recommended 3 minutes between rhythm analyses and defibrillation attempts, with pulse checks 1 minute after rhythm analysis and, if no palpable pulse, intravenous administration of 1 mg of epinephrine. Several process improvements were implemented during the study period, including community education and wider availability of automated external defibrillators (AEDs).

The overall rate of survival to discharge increased significantly from 18% during 2001–2005 to 25% during 2006–2008. Among patients with a shockable first rhythm, the rate increased significantly from 37% to 48%, and, among patients with witnessed arrest and shockable rhythm, the rate increased significantly from 37% to 52%. Rates of bystander cardiopulmonary resuscitation increased significantly from 60% to 73%.


Citation(s):

Lindner TW et al. Good outcome in every fourth resuscitation attempt is achievable — An Utstein template report from the Stavanger region. Resuscitation 2011 Jun 27; [e-pub ahead of print].