Community Approaches to Improve Resuscitation After Out-of-Hospital Sudden Cardiac Arrest

摘要: Sudden cardiac arrest (SCA) is a major cause of mortality in North America and other westernized societies, accounting for ≈10% all deaths up to 50% heart disease–related death.1,2 The condition characterized by an unexpected cardiovascular collapse due underlying cause.3 This definition, although useful as intellectual foundation, challenged operational translation. challenge deriving working case definition SCA important because different approaches ascertainment classification can influence efforts aimed at estimating incidence, improving prevention strategies, or directing resuscitation care. For example, various strategies may be used determine incidence. Death certificates, emergency medical services (EMS) records, witness interviews, examiner reports singly combination ascertain classify SCA. Each approach has strengths limitations. certificate classification, are efficient defined specific objective coding criteria but often overestimate incidence the includes people who do not die suddenly truly from causes.4 Conversely, death certificates exclude were successfully resuscitated. Thus, “best” strategy depends large part on intent effort available resources. The present clinical summary discusses improve out-of-hospital therefore focuses treated EMS. From epidemiological perspective, EMS-treated, constitutes subset disease events. As such, it excludes in-hospital events that either have response receive no EMS treatment. latter circumstance arises typically when there signs prolonged, irreversible “do resuscitate” request documentation.5 Although community-specific heterogeneity exists with …