Wednesday, January 8, 2014

New Study shows the importance of following guidelines in cardiac arrest management

Anyone who works in pre-hospital care has to know that THE hot topic for the past 3-5 years has been cardiac arrest. New science is coming out every month. This is helping us rapidly refine the best practice for managing a cardiac arrest outside of the hospital.

Ahhh, outside of the hospital. What about in-hospital cardiac arrest? A NEJM article published in 2012 puts the survival rate at 22%. That is much better than out-of-hospital rates which are often quoted as below 10%. It seems logical that the survival rate would be better in a hospital, what better place to have and arrest than in the hospital.But, even if you are in a hospital, there may be some room for improvement.

Consider an article published right now in Resuscitation.Title:

The effect of adherence to ACLS protocols on survival of event in the setting of in-hospital cardiac arrest.

The article says that when a person arrests in the hospital, they have a greater chance of ROSC if ACLS guidelines are followed. They make the point that omitting interventions, or adding in your own that are not part of the protocol, leads to ROSC less often.

This is the key. Managing a cardiac arrest is not a free for all. It needs to be done via a plan that everyone knows, agrees to and understands. It is not a time to be unprepared, random and unpredictable.