Optimizing Resuscitation After Cardiac Arrest in the Community

Cardiopulmonary Arrest Outcome

resuscitation, sudden death, cardiopulmonary resuscitation, emergency medical services, termination of resuscitation, ventricular fibrillation, out-of-hospital cardiac arrest, asystole, medical futility, withdrawing treatment, transportation of patients, health expenditures, healthcare costs

Resuscitative efforts have been shown to be unsuccessful in most cases of out-of-hospital cardiac arrest (OHCA), and survivors who do recover cardiac function often sustain severe hypoxic brain damage. Time to efficacious care is a primary determinant of disability-free survival. In the Jerusalem district, only 9% of OHCA patients present with ventricular tachycardia/ventricular fibrillation (VT/VF) as the primary rhythm, whereas 77% present with asystole; this seems primarily to be the result of long collapse-to-arrival times. Nevertheless, overly zealous resuscitation is undertaken in a high proportion of arrests with a futile prognosis, leading to excessive costs. Study hypotheses: 1. Subpopulations for whom intervention is futile/counter-productive are identifiable 2. Substantial waste of resources can be avoided 3. Optimization of emergency medical services (EMS) reorganization without adding resources is an achievable goal

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