Nov. 9, 2007
UI, Iowa communities add to study: improved cardiac arrest survival
The University of Iowa, several Iowa communities and their EMS agencies provided data to a recent study that showed cardiopulmonary resuscitation (CPR) combined with bystander use of an automated external defibrillator (AED) more than doubled the chances of surviving out-of-hospital cardiac arrest compared to CPR alone.
The findings by a research group led by the Johns Hopkins University were reported at the American Heart Association's Scientific Sessions 2007 earlier this month.
Based on national statistics on out-of-hospital cardiac arrest, researchers estimated that bystander CPR plus use of an AED in the United States and Canada saves 522 lives a year.
"By participating in this study and related efforts, the Iowa communities are helping define the best and new treatments for out-of-hospital cardiac arrest and life-threatening trauma," said Dianne Atkins, M.D., professor of pediatrics at the UI Roy J. and Lucille A. Carver College of Medicine and a pediatric cardiologist with UI Children's Hospital.
Several years ago, the National Institutes of Health-sponsored Public Access Defibrillation (PAD) trial showed that specifically training lay volunteers to perform CPR and use AEDs placed in public buildings doubled the number of survivors from out-of-hospital cardiac arrest compared with training bystanders to deliver CPR alone.
The new study did not train specific bystanders to respond, but included data about patients who had out-of-hospital cardiac arrests between Dec. 1, 2005, and Nov. 30, 2006, and were evaluated by emergency medical service (EMS) personnel. The study was based on review of medical outcomes, so no consent was required of any patient and identifying information was not needed.
The findings came from a study of sites in the Resuscitations Outcomes Consortium (ROC), a network of communities involved in studies of pre-hospital emergency care. The Iowa communities and one county that contributed included Bettendorf, Davenport, Des Moines, Dubuque, Mt. Pleasant, Sioux City, Waterloo, West Des Moines and Johnson County. Cedar Rapids was also included for this data but no longer participates in ROC.
A total of 10,663 EMS-treated patients were included in the study. Bystanders administered CPR in 3,191 cases (29.9 percent) and used an AED with CPR in 259 cases (2.4 percent). Overall, 7 percent of the 10,663 patients survived to hospital discharge. However, survival varied substantially according to the type and timing of resuscitation attempted.
Of patients who had bystander CPR but no use of an AED, just 9 percent survived to hospital discharge. When bystanders provided CPR and attached an AED and the device delivered a shock, survival increased to 36 percent or approximately four times that of CPR alone.
"Many of the Iowa communities included in this study had developed Public Access Defibrillation programs. This study demonstrates the life-saving capabilities of these programs," said Atkins, who also is a member of the UI ROC team.
The EMS agencies in these towns also played an important role in the study, she added, as they submit their information through Iowa EMA Patient Registry, which is maintained by the Iowa Bureau of Emergency Medical Services, a division of the Iowa Department of Public Health.
The EMS agencies involved in this study included Bettendorf Fire, Davenport Medic EMS, Davenport Fire, Des Moines Fire EMS, West Des Moines EMS, Dallas County EMS, Dubuque Fire EMS, Johnson County Ambulance Service (EMS), Iowa City Fire, Henry Co. Health Center EMS (Mt. Pleasant area), Siouxland EMS, Sioux City Fire, Wheaton Franciscan EMS (Waterloo area) and Waterloo Fire.
The UI also received some data directly from participating sites in Iowa, and all the information was submitted to the ROC Data Coordinating Center at the University of Washington in Seattle for analysis.
The study was supported by the National Heart, Lung, and Blood Institute, Canadian Health and Defense Agencies, and the American Heart Association.
For more information, see the AHA news release at http://www.americanheart.org/presenter.jhtml?identifier=3050869
NOTE TO EDITORS: This news release includes information from an 11/05/07 release issued by the American Heart Association.
STORY SOURCE: Health Science Relations, University of Iowa, 5137 Westlawn Lawn, Iowa City, IA 52242
MEDIA CONTACT: Becky Soglin, Health Science Relations, 319-335-6660, firstname.lastname@example.org.