Figure 1: Cardiac arrest survival statistics before and after cath lab activation protocol change
Cerebral performance category (CPC) scores:
1. Conscious and alert with normal function or only slight disability
2. Conscious and alert with moderate disability
3. Conscious with severe disability
4. Comatose or persistent vegetative state
24 Advances in Resuscitation
to over 13,000 followers locally.
In addition, LFR worked diligently on focused
training and improvement in prehospital provider high-performance CPR. We now complete a
comprehensive post-event analysis of every cardiac
arrest utilizing the Code-Stat data review software
from Physio-Control. It includes quality metrics
such as chest compression fraction, the number of
compression pauses greater than 10 seconds, the
single longest compression pause and the ventilation rate during the cardiac arrest.
A post-event worksheet highlighting performance and suggestions for improvement is provided for each of the EMS providers who responded
to the cardiac arrest. Upon recognizing that significant CPR pauses occurred while moving a patient
in unresolved arrest to an ambulance, a protocol
change was made directing providers to remain
on scene while attempting resuscitation, rather
than initiating immediate transport to a hospital.
In order to further enhance CPR quality and pro-
mote EMS provider safety if a cardiac arrest patient
is transported, LFR initiated a field evaluation of
the LUCAS mechanical CPR device.
After reviewing our initial cardiac arrest mortality data, we noted a significant number of patients
who suffered a witnessed ventricular fibrillation/
ventricular tachycardia (v fib/v tach) cardiac arrest
and survived to hospital admission, but didn’t
survive to hospital discharge.
As we reviewed the hospital care these patients
received, we noted intermittent initiation of therapeutic hypothermia along with inconsistent phi-losophies on which patients were candidates for
catheterization lab intervention.
Designing a New Protocol
Reviewing the most compelling cardiac research,
survival from shockable cardiac arrest is strongly
correlated with cardiac catheterization laboratory