10 steps for better survival after cardiac arrest

Steps for better survival after cardiac arrest

1. Establish a cardiac arrest record

A register of cardiac arrest is a prerequisite for keeping statistics. Continuous statistics show whether implemented changes lead to improvement and help identify where further development is needed. A register not only shows whether the patient survives or dies, but covers all aspects of care.

2. Introduce CPR training over the phone and improve quality

The alarm receiver is the extremely important first link in the survival chain. Many emergency services have ready-made routines for various emergency situations, but usually do not offer CPR over the telephone (T-CPR). Being able to identify cardiac arrest and help alarming spectators with CPR over the phone has been shown to give better results.

3. Invest in high-performance CPR

High-performing CPR is about team efforts at the highest level. The time from collapse to the onset of CPR is important for the chances of survival - but the quality of the CPR intervention is at least as important. Continuous training and quality development are the most important areas to ensure high-performing CPR.

4. Shorten the time to call

The chance of survival decreases by 10 percent for each minute of CPR delay and defibrillation. Rapid ambulance calls can thus increase survival by 5–10 percent, without requiring additional personnel or resources. To succeed, a clear list of incidents / symptoms is required that should initiate rapid response and statistics should be kept over time for response. As soon as a critical symptom is mentioned in the event of an alarm, an emergency call must be made immediately.

5. Register professional resuscitations

The defibrillator recording device creates a digital register with important information that can be used to reconstruct events. Second-to-second data on heart rate and CPR, synchronized with digital voice recording, provide an overall picture of the heart event that users can review and learn from.

6. Establish a defibrillator program for rescue workers

Efforts from rescue services or other public personnel such as police or security guards have the potential to increase survival after cardiac arrest. In some places where the police have been trained in using defibrillators, it has been possible to see dramatic improvements in terms of survival. To succeed, there must be full support from both the police and the ambulance service, and all police officers must receive individual practical training, rather than just video or web-based training.

7. Use smart technology to speed up CPR and label defibrillators

Rescue efforts in the event of cardiac arrest are based on teamwork. With smart technology, volunteers in the vicinity of a cardiac arrest can be alerted and the location of the nearest defibrillator (AED) identified. The possibility for volunteers to intervene before rescue personnel are on site increases the chances of survival.

8. Make CPR training and pacemakers mandatory in society

An entire population that has been trained in CPR has the potential to double survival. In many countries, CPR training has been compulsory in schools for several years. In the United States, 34 states have made CPR training compulsory for high school students to graduate. This means that over 2 million students are trained in CPR every year.

9. Work for responsibility

Annual performance review of rescue efforts is the best way to determine the responsibility towards society. A system that is transparent with its results conveys important information. The information can be used to reward the organization if the results are positive. If the results are not positive, the information can be used to motivate senior officials and politicians to invest in improvement efforts.

10. Work for a culture with a high level of ambition

Creating and promoting a culture with a high level of ambition is the most difficult step. A culture with a high level of ambition means that the organization's members subconsciously perceive that high expectations and high performance are what define care. This in turn requires that the management has a convincing vision and a long-term plan. Establishing and maintaining a culture with a high level of ambition requires constant quality improvement.