Improving Survival After Cardiac Arrest in Europe: The Synergetic Effect of Rescue Chain Strategies

Overview

Journal Resusc Plus

Date 2024 Jan 11

PMID 38205146

Authors

Lina Horriar

Nadine Rott

Bernd W Bottiger

Affiliations

Soon will be listed here.

Abstract

Sudden cardiac arrest is a global problem and is considered the third leading cause of death in industrialized countries. Patient survival rates after out-of-hospital cardiac arrest (OHCA) vary significantly between countries and continents. In particular, the 2021 European Resuscitation Council (ERC) Resuscitation Guidelines place a special focus on the chain of survival of patients after OHCA. As a complex, interconnected approach, the focus is on: Raising awareness for cardiac arrest and lay resuscitation, school children's education in resuscitation "KIDS SAVE LIVES", first responder systems - technologies to engage the community, telephone-assisted resuscitation (telephone-CPR; T-CPR) by dispatchers, and cardiac arrest centers (CAC) for further treatment in specialized hospitals. The Systems Saving Lives approach is a comprehensive strategy that emphasizes the interconnectedness of all links in the chain of survival following an OHCA, with a particular focus on the relationship between the community and emergency medical services (EMS). This system-level approach emphasizes the importance of the connection between all those involved in the chain of survival. It has a high potential to improve overall survival after OHCA. Therefore, it is recommended that these strategies be promoted and expanded in all countries.

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References

Deakin C . The chain of survival: Not all links are equal. Resuscitation. 2018; 126:80-82. DOI: 10.1016/j.resuscitation.2018.02.012. View

Blom M, Beesems S, Homma P, Zijlstra J, Hulleman M, van Hoeijen D . Improved survival after out-of-hospital cardiac arrest and use of automated external defibrillators. Circulation. 2014; 130(21):1868-75. DOI: 10.1161/CIRCULATIONAHA.114.010905. View

Cummins R, Chamberlain D, Abramson N, Allen M, Baskett P, Becker L . Recommended guidelines for uniform reporting of data from out-of-hospital cardiac arrest: the Utstein Style. A statement for health professionals from a task force of the American Heart Association, the European Resuscitation Council, the Heart and.... Circulation. 1991; 84(2):960-75. DOI: 10.1161/01.cir.84.2.960. View

Cummins R, Ornato J, Thies W, Pepe P . Improving survival from sudden cardiac arrest: the "chain of survival" concept. A statement for health professionals from the Advanced Cardiac Life Support Subcommittee and the Emergency Cardiac Care Committee, American Heart Association. Circulation. 1991; 83(5):1832-47. DOI: 10.1161/01.cir.83.5.1832. View

Grasner J, Wnent J, Herlitz J, Perkins G, Lefering R, Tjelmeland I . Survival after out-of-hospital cardiac arrest in Europe - Results of the EuReCa TWO study. Resuscitation. 2020; 148:218-226. DOI: 10.1016/j.resuscitation.2019.12.042. View

Bottiger B, Lockey A, Aickin R, Carmona M, Cassan P, Castren M . Up to 206 Million People Reached and Over 5.4 Million Trained in Cardiopulmonary Resuscitation Worldwide: The 2019 International Liaison Committee on Resuscitation World Restart a Heart Initiative. J Am Heart Assoc. 2020; 9(15):e017230. PMC: 7792236. DOI: 10.1161/JAHA.120.017230. View

Scquizzato T, Pallanch O, Belletti A, Frontera A, Cabrini L, Zangrillo A . Enhancing citizens response to out-of-hospital cardiac arrest: A systematic review of mobile-phone systems to alert citizens as first responders. Resuscitation. 2020; 152:16-25. PMC: 7211690. DOI: 10.1016/j.resuscitation.2020.05.006. View

Stieglis R, Zijlstra J, Riedijk F, Smeekes M, van der Worp W, Tijssen J . Alert system-supported lay defibrillation and basic life-support for cardiac arrest at home. Eur Heart J. 2021; 43(15):1465-1474. PMC: 9009403. DOI: 10.1093/eurheartj/ehab802. View

Stroop R, Kerner T, Strickmann B, Hensel M . Mobile phone-based alerting of CPR-trained volunteers simultaneously with the ambulance can reduce the resuscitation-free interval and improve outcome after out-of-hospital cardiac arrest: A German, population-based cohort study. Resuscitation. 2019; 147:57-64. DOI: 10.1016/j.resuscitation.2019.12.012. View

10.

Tiwari L, Lockey A, Bottiger B, Rott N, Hoover A, Chakra Rao S . More than 302 million people reached and over 2,200,000 trained in cardiopulmonary resuscitation worldwide: The 2021 ILCOR World Restart a Heart initiative. Resusc Plus. 2023; 14:100375. PMC: 10060744. DOI: 10.1016/j.resplu.2023.100375. View

11.

Semeraro F, Greif R, Bottiger B, Burkart R, Cimpoesu D, Georgiou M . European Resuscitation Council Guidelines 2021: Systems saving lives. Resuscitation. 2021; 161:80-97. DOI: 10.1016/j.resuscitation.2021.02.008. View

12.

Oving I, de Graaf C, Masterson S, Koster R, Zwinderman A, Stieglis R . European first responder systems and differences in return of spontaneous circulation and survival after out-of-hospital cardiac arrest: A study of registry cohorts. Lancet Reg Health Eur. 2022; 1:100004. PMC: 8454711. DOI: 10.1016/j.lanepe.2020.100004. View

13.

Scquizzato T, Burkart R, Greif R, Monsieurs K, Ristagno G, Scapigliati A . Mobile phone systems to alert citizens as first responders and to locate automated external defibrillators: A European survey. Resuscitation. 2020; 151:39-42. DOI: 10.1016/j.resuscitation.2020.03.009. View

14.

Viereck S, Moller T, Ersboll A, Baekgaard J, Claesson A, Hollenberg J . Recognising out-of-hospital cardiac arrest during emergency calls increases bystander cardiopulmonary resuscitation and survival. Resuscitation. 2017; 115:141-147. DOI: 10.1016/j.resuscitation.2017.04.006. View

15.

Nielsen A, Isbye D, Lippert F, Rasmussen L . Can mass education and a television campaign change the attitudes towards cardiopulmonary resuscitation in a rural community?. Scand J Trauma Resusc Emerg Med. 2013; 21:39. PMC: 3666962. DOI: 10.1186/1757-7241-21-39. View

16.

Berdowski J, Berg R, Tijssen J, Koster R . Global incidences of out-of-hospital cardiac arrest and survival rates: Systematic review of 67 prospective studies. Resuscitation. 2010; 81(11):1479-87. DOI: 10.1016/j.resuscitation.2010.08.006. View

17.

Metelmann C, Metelmann B, Herzberg L, Auricchio A, Baldi E, Benvenuti C . More patients could benefit from dispatch of citizen first responders to cardiac arrests. Resuscitation. 2021; 168:93-94. DOI: 10.1016/j.resuscitation.2021.09.026. View

18.

Wissenberg M, Lippert F, Folke F, Weeke P, Hansen C, Christensen E . Association of national initiatives to improve cardiac arrest management with rates of bystander intervention and patient survival after out-of-hospital cardiac arrest. JAMA. 2013; 310(13):1377-84. DOI: 10.1001/jama.2013.278483. View

19.

Rea T, Fahrenbruch C, Culley L, Donohoe R, Hambly C, Innes J . CPR with chest compression alone or with rescue breathing. N Engl J Med. 2010; 363(5):423-33. DOI: 10.1056/NEJMoa0908993. View

20.

Baldi E, Savastano S, Contri E, Lockey A, Conaghan P, Hulme J . Mandatory cardiopulmonary resuscitation competencies for undergraduate healthcare students in Europe: A European Resuscitation Council guidance note. Eur J Anaesthesiol. 2020; 37(10):839-841. DOI: 10.1097/EJA.0000000000001272. View