Resuscitation Remains a Significant Challenge to Improving Healthcare Outcomes
August 23, 2017
By Marnie Kelly, Vice President, Resuscitation Solutions, HealthStream
Many of us have perceptions from popular television shows that resuscitation is almost always effective; however, the truth is that we are really not as good at resuscitating as you might think. Currently, we are only able to revive about 24.8% of those with in-hospital cardiac arrest.
New research shows that more frequent CPR training is needed in our healthcare organizations and that real-time feedback using voice-assisted manikins can greatly improve students’ skills at resuscitation. Even long-time CPR instructors have been shocked to discover that they do not pass tests incorporating the more sophisticated tools that can be leveraged to measure performance.
Most hospitals in the U.S. use traditional classroom instruction to train employees in CPR, with only about 30% making the switch to the American Heart Association’s HeartCode® program that includes online instruction coupled with practice using Voice-Assisted Manikins. Those who have made the upgrade have seen improvements in CPR quality, code response rates, and employee confidence and competence.
Cardiac Arrest is a Leading Cause of Death
Internationally, more than 135 million cardiovascular deaths occur each year, and this number is increasing. Across the globe, for every 100,000 people, cardiac arrests range from 20-140 people. Unfortunately, survival rates are low and range from 2 – 11 %.
In the U.S., survival rates are slightly higher but still less than 15%. Cardiac arrest is a leading killer in the U.S. “claiming more lives than colorectal cancer, breast cancer, prostate cancer, influenza, pneumonia, auto accidents, HIV, firearms, and house fires combined.”
Even in hospital settings, survival rates are surprisingly low and typically range from 15 – 20%. Interestingly, there is a difference in survival rate based on the time of day that the arrest occurs. For example, there is a 20% survival rate if the arrest occurs between 7 AM and 11 PM. However, the survival rate drops to 15% if the arrest occurs between 11 PM and 7 AM. Other research also reported that there is a survival difference based on the interaction between location in the hospital and time of the arrest. There is only a 9% survival rate if the arrest occurs in an unmonitored setting at night. The rate increases to about 37% if the arrest occurs during the day in the operating room or a post-anesthesia unit. Clearly, there is an opportunity in the U.S. healthcare system to reduce variation and improve overall survival rates from cardiac arrest.
High-Quality CPR is a Helpful Defense
Prompt and effective CPR intervention has shown to be helpful in improving survival from cardiac arrest. The amount of time between the cardiac event and the performance of high-quality CPR is related to survival. The depth and rate of compressions used during CPR has also been shown to impact the outcome of cardiac arrest. “When rescuers compress at a depth of <38 mm, survival-to-discharge rates after out-of-hospital arrest are reduced by 30%. Similarly, when rescuers compress too slowly, return of spontaneous circulation (ROSC) after in-hospital cardiac arrest falls from 72% to 42%.” In the 2010 Consensus Statement of the American Hospital Association, Dr. Peter A. Meaney, MD, MPH, of Children’s Hospital of Philadelphia, and colleagues conclude, “Poor-quality CPR should be considered a preventable harm.”
This blog post excerpts an article from our recent eBook, High-Quality CPR: Breathing New Life Into Your Training Program, available for download here.