Methodology in cardiac arrest research symposium

Abstract

On November 25, 1987, the mayor of Chicago sat working at his desk, when he suddenly slumped unresponsive to the floor. The mayor's bodyguards noted no puIse and started CPR immediately The chief paramedic officer for the city arrived in the mayor's office and began advanced cardiac life support procedures several minutes after the mayor's collapse, noting an ominous initial rhythm of asystole. Thirty-three minutes later, the mayor arrived at the emergency department at Northwestern Memorial Hospital, where a waiting cardiovascular team placed him on complete cardiac bypass and quickly moved him to the operating suites. However, despite these rapid and heroic efforts, Harold Washington became the second Chicago mayor in 15 years to die from cardiac arrest while in office. He was one of 3,500 Chicago citizens to die from cardiac arrest during that year; only 55 cardiac arrest victims survived to leave the hospital, resulting in an overall survival rate of less than 2%. ~ Had it not been for the fact that the mayor died, it might have been a perfect resuscitation. ''2 However, we must examine the facts squarely Very little has changed in the actual treatment of cardiac arrest over the last 15 years) Despite the fact that a few communities have survival rates of more than 15%, most communities' rates are closer to the 2% found in Chicago. Even in communities where 20% survival rates are found, the other 80% still die from cardiac arrest. The actual experience of most ED staff is far from encouraging. Many physicians have voiced skepticism regarding the usefulness of current treatment protocols and emergency medical services for cardiac arrest. Equally disturbing is the fact that most communities simply have no idea what their survival rates are because they do not measure them. Because the survival rate in Chicago was less than 2%, we were naturally interested in comparing our results with those from other communities. However, this was an impossible task due to the lack of uniform methodology