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Survival Rates for out
of hospital cardiac
arrest decrease in NSW! |
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The Australian Resuscitation Council's (ARC) NSW Branch, last month released a paper showing that more people are dying from cardiac arrest survival in NSW than a few years ago. People who have a cardiac arrest outside hospital in NSW are now less likely to survive than they were in the past, a major new study has found.
The study, to be published this week examined NSW Ambulance Service data, to determine the number of people who had out-of-hospital cardiac arrests and their survival rates. It compared two one-year periods, in 2004-05 and 2009-10, to test how cardiac arrest survival rates had changed over time.
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The main
findings of
the study
are:
-
The
incidence
cardiac
arrest
fell
during
the
study
period.
In
2004-05,
there
were
52.6
out-of-hospital
cardiac
arrests
in NSW
for
every
100,000
people.
By
2009-10
this had
fallen
to 48.4
out-of-hospital
cardiac
arrests
for
every
100,000
people.
This
suggests
fewer
people
in NSW
are
having
out-of-hospital
cardiac
arrests.
-
12.3% of
people
who had
an
out-of-hospital
cardiac
arrest
in NSW
in
2004-05
were
still
alive 90
days
later.
By
comparison,
only
10.2% of
people
who had
an
out-of
hospital
cardiac
arrest
in
2009-10
were
alive 90
days
later.
This
suggests
a
significant
decrease
in
survival
rates.
The findings
of this
latest study
contrast the
general
upward trend
in survival
of Cardiac
Arrest.
The NSW ARC
Branch is
calling on
the state
government
to take
action to
reverse the
decline in
the survival
rate.
Editor's
note:
If we look
at the
American
attitude to
improving
cardiac
arrest
survival
rates it is
nothing
short of
impressive.
Two short
years ago,
they
radically
changed the
guidelines
for lay
person CPR.
At the same
time
'compression
only CPR'
was
introduced
across the
country. If
a bystander
is not
trained in
CPR, the
bystander
should
provide
'compression-only
CPR' for the
adult victim
who suddenly
collapses,
with an
emphasis to
"push hard
and fast" on
the center
of the
chest, or
follow the
directions
of the EMS
dispatcher.
The rescuer
should
continue
Hands-Only
CPR until an
AED arrives
and is ready
for use or
EMS
providers or
other
responders
who take
over care of
the victim.
Cardiac
arrest
victims may
present with
seizure-like
activity or
agonal gasps
that may
confuse
potential
rescuers.
Dispatchers
should be
specifically
trained to
identify
these
presentations
of cardiac
arrest to
improve
recognition
the of
cardiac
arrest and
prompt
provision of
CPR. To help
bystanders
recognize
cardiac
arrest,
dispatchers
should ask
about an
adult
victim's
responsiveness,
if the
victim is
breathing
and if the
breathing is
normal, in
an attempt
to
distinguish
victims with
agonal gasps
(ie, in
those who
need CPR)
from victims
who are
breathing
normally
and do not
need CPR.
The lay
rescuer
should be
taught to
begin CPR if
the victim
is 'not
breathing or
only
gasping'.
The
healthcare
provider
should be
taught to
begin CPR if
the victim
has 'no
breathing or
no normal
breathing (ie,
only
gasping)'.
Note the
emphasis on
'gasping'
and
'seizure-like
activity'.
In Australia
if one was
to quiz all
First Aid
instructors
about the
relevance of
these
phenomena
and how they
pertain to
the early
recognition
of Cardiac
Arrest, we
would be
dismayed at
the lack of
knowledge in
this area.
This
information
is simply
not being
taught at
the basic
level of
CPR! |
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In Seattle,
USA, the
statistics
of survival
from
out-of-hospital-cardiac
arrest are
amazing (see
graph). The
survival
rate from
Cardiac
Arrest in
King County
has reached
an all time
high of 57%.
This is in
stark
contrast to
the national
average of
around 10%.
This city
has embarked
upon a
massive
educational
program to
have all
citizens
trained in
basic CPR
and the
inclusion of
'compression
only CPR'
has played a
vital part
in this
success
story.
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Unfortunately
in
Australia,
cardiac
arrest
'victims'
are thought
of just that
- 'victims'.
Until we see
these people
as patients, we may not
see a change
in the poor
outcomes.
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