Improving the quality of CPR in the Community

Abstract

An out of hospital cardiac arrest (OHCA) is defined as cessation of cardiac mechanical activity, confirmed by the absence of signs of circulation and that which occurs outside the hospital setting (Roger VL, 2011) About 70–85% of these events have a cardiac cause. Published literature identifies acute coronary syndrome (ACS) as the most frequent cause of OHCA, particularly among elderly and coronary vasospasm as a considerable cause among young healthy individuals. It can also occur from non-cardiac causes such as trauma, drowning, drug overdose, asphyxia, electrocution and primary respiratory arrests. (Sasson C, Kellermann AL. 2010). Early cardiopulmonary resuscitation (CPR), therapeutic hypothermia and early advanced care have a crucial role in management of OHCA. Every minute lost in initiating CPR leads to 10% decrease in survival rates of the victim (Go AS, Mozaffarian D-2013) since members of the community are the first to witness OHCA, there is an increasing recognition of the need to coordinate with the community in providing emergency medical care to optimize patient survival after an OHCA. American Heart Association (AHA) guidelines for cardiopulmonary resuscitation and emergency cardiovascular care describes a “chain of survival” to reduce mortality and improve survival. The “chain of survival” comprises of five elements, namely, immediate recognition and rapid access, rapid CPR, rapid defibrillation, effective advanced care and integrated post cardiac arrest care. (Travers AH-: 2010)