Improving survival after out-of-hospital cardiac arrest

Sudden cardiac arrest results in millions of deaths worldwide each year and is a leading cause of premature death, with large disparities in survival between less privileged and more privileged groups.1 Despite this, there has been relatively little attention given to policies and strategies to improve the outcomes of cardiac arrest.

Cardiac arrest is commonly associated with low survival rates and poor functional outcome in survivors, but recent data show that both are improving.2 3 Nevertheless, there remains much scope for communities to improve outcomes to match those in the best performing places.4

The US Institute of Medicine’s report on strategies to improve survival from cardiac arrest is therefore timely.5 It focuses on five areas: cardiopulmonary resuscitation (CPR) and the use of automated external defibrillators (AEDs); emergency medical systems and hospital systems of resuscitation care; national cardiac arrest statistics; resuscitation research; and future treatments and strategies for improving outcomes. The main recommendations are familiar to those involved in healthcare systems and quality improvement. They include establishing a national cardiac arrest registry, fostering a culture of action through public awareness and training, enhancing the capabilities and performance of emergency medical systems, setting accreditation standards for hospitals and …