Acting on the Call

On June 6-7, 2015, at the Utstein Abbey near Stavanger, Norway, 36 Emergency Medical Services (EMS) leaders, researchers, and experts from throughout the world convened to address the challenge of how to increase community cardiac arrest survival and how to achieve implementation of best practices and worthwhile programs.

The attendees called for the establishment of a Global Resuscitation Alliance (GRA) and issued a report laying out ten programs to improve survival and ten steps to achieve successful implementation. The GRA expands internationally the reach and utility of the Resuscitation Academy concept developed in King County, Seattle since 2008. Such a global effort will promote best practices and offer help with implementation to countless communities.

Survival from Sudden Cardiac Arrest (SCA) is tragically and unacceptably low.

Furthermore, there is 15-fold disparity is survival from ventricular fibrillation cardiac arrest. High-performance communities consistently achieve survival greater than 50 percent. An estimated 1 million persons die every year from cardiac arrest in high-resource countries. This call to action declares the current situation to be unacceptable.

The GRA states:

• Communities can and must do better.
• Based upon current knowledge that with adherence to and implementation of best practices, communities can increase survival from cardiac arrest by 50 percent.
• The GRA will help educate EMS leaders about best practices and provide tools to help improve survival in their communities.
• The likelihood of surviving declines by approximately 10 percent for every minute after onset, Timely application of several critical interventions determines outcome.

These interventions include: rapid dispatch, telephone cardiopulmonary resuscitation (T-CPR), EMS at scene, EMS with patient to begin CPR and defibrillation, provision of high performance CPR (HP-CPR), and bystander defibrillation. The time and quality of these interventions define poor, average, and best performing EMS systems.

Poorly performing EMS systems with approximate survival of 10 percent do not have rapid dispatch, telephone CPR, or HP-CPR. Time to defibrillation is 10 minutes with no or little bystander CPR. Average systems also do not have rapid dispatch but they do have T-CPR (albeit delayed) and HP-CPR. Average survival is 30 percent. EMS systems with best practices have rapid dispatch, quick deliver of T-CPR instructions, and HP-CPR. Survival is 50 percent.

The GRA believes that defibrillation by a bystander within 2 1/2 minutes is a future reality. Though not a reality today, technology for inexpensive consumer AEDs is close at hand. When these consumer AEDs disseminate into homes and apartments, the opportunity for very rapid defibrillation and survival rates of 75 percent can become a reality.

For more information, visit the Global Resuscitation Alliance.

SOURCE: Global Resuscitation Alliance