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Semin Neurol 2017; 37(01): 025-032
DOI: 10.1055/s-0036-1593890
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Improving Survival after Cardiac Arrest

Conrad Arnfinn Bjørshol
1   Department of Anaesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway
2   Department of Clinical Medicine, University of Bergen, Bergen, Norway
,
Eldar Søreide
1   Department of Anaesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway
2   Department of Clinical Medicine, University of Bergen, Bergen, Norway
3   Department of Health Care Sciences, University of Stavanger, Stavanger, Norway
› Author Affiliations
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Publication History

Publication Date:
01 February 2017 (online)

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Abstract

Each year, approximately half a million people suffer out-of-hospital cardiac arrest (CA) in Europe: The majority die. Survival after CA varies greatly between regions and countries. The authors give an overview of the important elements necessary to promote improved survival after CA as a function of the chain of survival and formula for survival concepts. The chain of survival incorporates bystanders (who identify warning symptoms, call the emergency dispatch center, initiate cardiopulmonary resuscitation [CPR]), dispatchers (who identify CA, and instruct and reassure the caller), first responders (who provide high-quality CPR, early defibrillation), paramedics and other prehospital care providers (who continue high-quality CPR, and provide timely defibrillation and advanced life support, transport to CA center), and hospitals (targeted temperature management, percutaneous coronary intervention, delayed prognostication). The formula for survival concept consists of (1) medical science (international guidelines), (2) educational efficiency (e.g., low-dose, high-frequency training for lay people, first responders, and professionals; and (3) local implementation of all factors in the chain of survival and formula for survival. Survival rates after CA can be advanced through the improvement of the different factors in both the chain of survival and the formula for survival. Importantly, the neurologic outcome in the majority of CA survivors has continued to improve.

Keywords

cardiac arrest - cardiopulmonary resuscitation - survival
 

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