SAEM: AHA guidelines lead to increased survival rates for cardiac arrest patients

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The new guidelines suggested by the American Heart Association (AHA) using compression, ventilation and induced hypothermia on cardiac arrest patients has led to a significant improvement in survival rates, according to a study presented at the 2008 Society for Academic Emergency Medicine (SAEM) meeting in Washington, D.C., last week.

Paul Hinchey, MD, and Brent Myers, MD, of the Wake County Emergency Medical Services (EMS) System in Raleigh, N.C., found that when the treatment protocol was fully implemented, it increased the odds of survival nearly four-fold for victims of cardiac arrest.

From January 2004 through October 2007, the researchers examined 2,594 out-of-hospital cardiac arrests in patients aged 15 and older (mean age 65; 58 percent male).

The study was based on the outcomes of adults treated for cardiac arrest by emergency responders in an urban and suburban EMS system with existing advanced life support.

Overall, the researchers found that survival increased from 2.4 percent using older guidelines to 6.7 percent after the introduction of the full 2005 AHA protocol.

The entire protocol was introduced for less than $200 per patient, according to Myers, medical director at EMS System. “All of these changes are simple, they are inexpensive and they are incredibly effective," he added.

The researchers highlighted the benefits of a healthcare community being able to implement a comprehensive care plan for victims of cardiac arrest “from the living room of the victim's home to the intensive care unit.”

There is ample evidence to support the use of continuous compressions and induced hypothermia. However, Hinchey and Myers said that unlike previous studies that demonstrate the effectiveness of individual interventions on a study population, this study demonstrates the “substantial impact that comprehensive implementation of a multi-disciplinary treatment protocol can have on a community.”

The essential elements of this plan were a focus on simple, continuous cardiac compressions; controlled ventilations; early utilization of induced hypothermia; and transport of resuscitated patients to specialized post-resuscitation hospitals.

“Our findings not only demonstrate beneficial outcomes for victims of cardiac arrest, but also suggest the possibility that such treatment plans can be implemented for other medical conditions,” the authors wrote.