Resuscitation science advances, more education needed

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Chris Kaiser, Editor

The science of resuscitation has advanced considerably in the past few decades. Yet, cardiac arrest survival at home or work has remained unchanged in that time. Not many homes are equipped with automated external defibrillators (AEDs), but many workplaces are. These devices are capable of directing bystanders to not only adequately shock patients, but also to perform life-saving CPR.

The American Heart Association (AHA) recently changed its guidelines for CPR, insisting that CPR be performed without breaks for mouth-to-mouth resuscitation. The theory behind the change is that continuous chest compressions–especially before the EMS personnel arrive on scene–lead to better survival rates.

An analysis of the SHARE program in Arizona showed that while the percentage of bystanders administering CPR increased only slightly over the past four years, three-quarters of those who did choose to help performed CPR according to the new AHA guidelines–that is, without intermittent mouth-to-mouth breathing, showing an increase from a previous rate of 16 percent to 77 percent.

Proper resuscitation techniques can be taught. That was one of the messages of an expert panel convened at the recent AHA meeting. The panel was mostly concerned with an international survey that found a large discrepancy between the perception of CPR delivery and the reality of its delivery.

The panel said it can be difficult sometimes trying to make changes where providers have been performing CPR for years. With the right feedback tools, however, providers learn quickly that their perception of their performance does not always match the reality. And almost all CPR performance improves post-training, members of the panel said.

These are exciting times for the science of resuscitation, with new cooling equipment and techniques, smart AEDs, better tests to predict those at risk of sudden cardiac arrest and better integration of hospital and EMS protocols. But more education needs to be done, with professionals as well as bystanders. These are ongoing efforts and as the population ages and the incidence of sudden cardiac arrest increases, we will be better equipped to save more lives.

On these of other topics, please send your comments or questions to me.

C.P. Kaiser, Editor

Cardiovascular Business