Cardiac Save Guidelines??

[DwayneEMTP]

During ACLS I asked the the instructor, who is also a Doc, what AHA considers a save and was told that their research defines a save as discharge plus 1 year.

Not sure if this helps, and didn't attempt to verify it...

Dwayne

[crazycanuck]

white 72: We should spend out time educating the public on the importance of CPR and AED training. Educate them to understand they can be a significant help in increasing the survival rate in cardiac arrest patients.

I could not agree more.

As far as my attitude sucking, its not an attitude its reality. Yes my expectations have everything to do with the outcome of arrest patients, give me a break. Maybe I should say a little prayer for them too, or work the arrest with my fingers crossed. That might help.

We know what saves arrest pts. I explained it above.

Thank you for expanding upon your points and thoughts. My post was not to pick at you or criticize your education or abilities. I misunderstood you to be saying there's not a hope in hell so why try, which is not really what you are saying I think.

Your point right here is of the utmost importance:

So if we are not going to put an ambulance on every corner, or educate the public, you will never see your arrest survival percentages rise.

The latter of the two seems more reasonable, no?

Outcome based measures and adapting treatment algorithms, protocols, and patient care are not the answer to saving everyone, and living in a rose-coloured glasses kind of world where people are saved by fairies and wishes is not going to help either.

Education is going to be what makes the difference. Education of the public to be more effective bystanders and primary prevention of heart disease and illness need to be a bigger focus than our currently short-sighted model of damage control....but that's a whole other discussion

Thanks for your comments whit. :wink:

[AnthonyM83]

Realistically, increasing of survival rates does have to come from public education. You need government support to spread the message, but it's been done. The whole wave about warning kids of strangers or the drug PSAs (whether they work or not, everyone's seen "this is your brain on drugs") or California's Click It or Ticket seatbelt campaign.

You can influence a community through media. And this is something people WANT to do...help their friends/family survive.

[AZCEP]

During ACLS I asked the the instructor, who is also a Doc, what AHA considers a save and was told that their research defines a save as discharge plus 1 year.

This is actually the AHA's definition of long term survival. It is also the standard they use to determine an intervention's effectiveness.

[whit72]

I couldnt agree more canuck. My personal feelings do not factor in. Everyone is given the same opportunity. We work every viable arrest with diligence, unfortunately we know what the outcome most likely will be. Once in a while the stars align and your able to save one, We don't say oh god we must be on to something here. No. Everything fell into place correctly, that allowed that person to be resuscitated. Thats why we continue to do it.

We are not failing because we are not trying. We thought ACLS would be the next great hope, well it didn't work. Then we put defibs on every truck. Taught BLS providers to use them, that didn't work. We have changed the CPR guide lines around multiple times. Nothing. We must continue to try. I just don't know how fruitful those efforts will be. Maybe somewhere down the line a combination of treatments or actions might prove to be successful.

[crazycanuck]

http://www.pubmedcentral.nih.gov/articlere...i?artid=1336161

Cardiac arrest in Ontario: circumstances, community response, role of prehospital defibrillation and predictors of survival.

R J Brison, J R Davidson, J F Dreyer, G Jones, J Maloney, D P Munkley, H M O'Connor, and B H Rowe

" from article linked above:

CONCLUSIONS: The survival rate was lower than expected. The availability of prehospital defibrillation did not affect survival. To improve survival rates after cardiac arrest ambulance response times must be reduced and the frequency of bystander-initiated CPR increased. Once these changes are in place a beneficial effect from advanced manoeuvres such as prehospital defibrillation may be seen."

http://www.aemj.org/cgi/content/abstract/8/5/424

The Relationship between Out-of-hospital Cardiac Arrest Survival and Community Bystander CPR Rates

Valerie J De Maio, Ian G Stiell, George A Wells, Michael T Martin, Daniel W Spaite, Graham Nichol, David Brisson, Donna Cousineau, Jeremy Doherty, Marion B Lyver, Brian J Field, Douglas P Munkley and , the OPALS Study Group

from above article:

"Conclusion: Improved community bystander CPR rates are associated with dramatically increased out-of-hospital arrest survival in a predictable fashion. EMS and public health directors should focus significant efforts towards improving their community bystander CPR rate."

*edit for formt

[Lilacmedic]

As I mentioned earlier the odds are stacked against us but even with those odds we must give our patients a fighting chance...

AED and CPR training is crucial but education starts way before that..education should start at pre-school level were kids are educated and encouraged about healthy living habits.

Because cardiac arrest or any cardiac/stroke related disease has a chronic path that it follows people in general don't take it that seriously and hold on to the belief that it could never happen to them.

With HIV/AIDS education all the stops are pulled-graphic pictures and dramatic movies were thrown at us by the media depicting dangerous behavior and then as a finale we see the and stages of AIDS.

The anti-smoke campaign is another example of such action.

Cardiac arrest/ Stroke hasn't received the same kind of coverage. How many teenagers aren't morbidly obese? Education should start earlier and then we might only have to respond to the rare cases where the patient is genetically predisposed.

Till then we can hammer out stats and have expensive research go into medications and operations....but unless we don't start emphasizing the importance of a healthy life style at a young age we can forget of ever beating our odds.

And here's a thought....how can we expect to deliver medical care and advice to patients when we ourselves look like we're candidates for cardiac surgery?

[Sdowler]

Are there any personnel from Calgary, Alberta EMS here? I believe that is a very progressive service with a very high save rate. I think JEMS did an article on them. Maybe they have some concrete definitions and science for what is a save?

[paramedicmike]

Are there any personnel from Calgary, Alberta EMS here? I believe that is a very progressive service with a very high save rate. I think JEMS did an article on them. Maybe they have some concrete definitions and science for what is a save?

What? The information on what the AHA uses to constitute a save wasn't good enough?

-be safe

[Sdowler]

sorry not my point. just an additional source.