Hostname: page-component-77c89778f8-n9wrp Total loading time: 0 Render date: 2024-07-19T10:29:01.012Z Has data issue: false hasContentIssue false

Cardiopulmonary Resuscitation — The Need for National Surveys

Published online by Cambridge University Press:  17 February 2017

D.A. Zideman
Affiliation:
Royal Postgraduate Medical School, Hammersmith Hospital, Ducane Road, London W12 OHS, UK

Extract

At the Second World Congress on Emergency and Disaster Medicine in Pittsburgh in 1981, Professor Negovsky talked about the Science of Resuscitation. Science is defined as systematic and formulated knowledge. Therefore, to be a science, resuscitation must be presented in accurate and concise terms. The introduction of Standards in the methodology of Resuscitation has achieved this. In 1977, the American Heart Association published Standards for Cardiopulmonary Resuscitation and Emergency Cardiac Care (1) and revised them in 1980 as Standards and Guidelines (2). Organizations in other countries have also introduced such standards: the Canadian Heart Foundation, the Heart Foundation of New Zealand, the Australian Resuscitation Council, and the Resuscitation Advisory Council in the United Kingdom; they all have systematic and formulated methodologies. The value of these standards and guidelines in Resuscitation methods can only be gauged by the results of various individual surveys. The definition of Resuscitation as a science runs into problems when one begins to examine these results. This paper will illustrate the difficulties of evaluating Resuscitation results.

Figure 1 shows a comparison of survival rates in5 centers (3-7) when Cardiopulmonary Resuscitation (CPR) was initiated by a rescue team or a bystander. It would appear that Seattle had the best overall survival rate, followed by Oslo. But Thompson and colleagues (5) from Seattle studied survival from cardiac arrest only when ventricular fibrillation was present when the paramedical personnel arrived. Lund and Skulberg (7) from Oslo did not state their type of victim, whereas Cobb and his colleagues (4) in suburban Seattle, with the lowest survival rates, looked at all forms of cardiac arrests.

Type
Section Four—Education
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1985

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Standards for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiac Care (ECC). JAMA 1974; 227(suppl): 833886.Google Scholar
2 Standards and Guidelines for Cardiopulmonary Resuscitaton (CPR) and Emergency Cardiac Care (ECC). JAMA 1980; 244(suppl): 453509.Google Scholar
3Nebraska Ambulance Rescue Information Reports 1978 and 1979.Google Scholar
4 Cobb, LA, Hallstrom, AP, Thompson, RG, et al. Community cardiopulmonary resuscitation. Ann Rev Med 1980; 31:453462.Google Scholar
5 Thompson, RG, Hallstrom, AP, Cobb, LA. Bystander initiated cardiopulmonary resuscitation in the management of ventricular fibrillation. Ann Intern Med 1979; 90:737740.Google Scholar
6 Guzy, PM, Pearce, ML, Greenfield, S, et al. Survival of out-of-hospital emergencies requiring cardiopulmonary resuscitation in Metropolitan Los Angeles. Clinical Research 1979; 27:278.Google Scholar
7 Lund, I, Skulberg, A. Cardiopulmonary resuscitation by lay people. Lancet 1976; 2:702705.Google Scholar
8 Goldstein, S, Landis, JR, Leighton, R, et al. Characteristics of the resuscitated out-of-hospital cardiac arrest victim with coronary heart disease. Circulation 1981; 64:977984.Google Scholar
9 Eisenberg, MS, Hearne, T. Pre-hospital emergency care in the USA: Effectiveness of paramedic and emergency medical technician units. In, Adgey, AAJ (ed). Acute Phase of Ischemic Heart Disease and Myocardial Infarction. Netherlands: Mortimer Nijhoff, 1982:151164.Google Scholar
10 Peatfield, RC, Sillett, RW, Taylor, D, et al. Survival after cardiac arrest in hospital. Lancet 1977; i: 12231225.Google Scholar
11 Scott, RPF. Cardiopulmonary resuscitation in a teaching hospital. Anaesthesia 1981; 36:526530.Google Scholar
12 Scott, RPF. Cardiac arrests in general wards: three year follow up. Lancet 1983; i:993.Google Scholar
13 DeBard, ML. Cardiopulmonary resuscitation: analysis of six years experience and review of the literature. Ann Emerg Med 1981; 10:408416.Google Scholar