Cardiac Arrest Survival: Global Dispatch CPR Intervention, 2013
In 2013, the Ramsey Social Justice Foundation committed to utilize strong international collaborations to implement a unique model for training and measuring the essential intervention whereby emergency medical dispatchers recognize cardiac arrest and deliver guideline-based pre-arrival CPR instructions to callers.
In every instance of Out of Hospital Cardiac Arrest (OHCA), rates of survival decline precipitously for each minute in which CPR is not performed. This presents a broad public health concerns and also creates substantial health costs.
The Collaborative efforts of the Ramsey Social Justice Foundation along with other EMS providers to improve dispatch-assisted CPR training and implementation in the state of Arizona has resulted in a tripling of the survival rate since 2004. This commitment will seek similar survival rate improvements around the world.
APPROACH
The goal of this three-year global healthcare initiative is to utilize strong international collaborations to efficiently implement dispatch-assisted CPR and to measure this intervention's impact on survival across 10 countries. The initiative's 'Bundle of Care' consists of new advanced evidence-based protocols and procedures, which will include scenario and video training of dispatchers; activation of real-time feedback measures; implementation of event debriefing; continuous data collection and measurement; and finally, the celebration of target successes.
The setting of this initiative will be the Pan-Asian Resuscitation Outcomes Study (PAROS) and the Cardiac Arrest Registry to Enhance Survival (CARES)
The PAROS network was established in 2010 as an international, multi-centre, prospective registry of OHCA across the Asia-Pacific, to date representing a population base of 89 million in 9 countries. It promotes collaboration by bringing together like-minded individuals to share experiences and develop joint initiatives for the betterment of Pre-hospital and Emergency Care (PEC). As a first step, PAROS has identified OHCA as one of its primary interests. The Network will gather valuable information on OHCA and deepen the understanding of the EMS systems in the region to devise strategies that improve survival.
In 2005, CARES began in the metropolitan Atlanta area. The following year, the program expanded to include 6 more cities. In 2011, 40 communities in 25 states and the District of Columbia were participating. CDC plans to expand the program to more areas as interest in CARES grows. In 2010, CARES began an expansion to statewide surveillance in Arizona, Hawaii, Minnesota, North Carolina, Pennsylvania, and Washington.
ACTION PLAN
This action plan consists of two levels of implementation:
The first stage will include implementation of dispatcher CPR training programs and protocols, including a standardized dispatcher-assisted CPR protocol, that were developed by Bentley J. Bobrow, MD, Arizona State Medical Director, Ramsey Community Services Foundation Medical Director and current Chairman of the American Heart Association Basic Life Support Subcommittee. It will also include a training video created in conjunction with the Ramsey Social Justice Foundation and Laerdal Medical. In addition, there will be a one-hour interactive web-based instructional video that will be based upon AHA Guidelines that were finalized in February 2013.
The next implementation level will include the introduction of dispatcher CPR training programs and protocols with six focus areas: an interactive website with updated training information; a one-day intensive dispatch training academy; a Dispatch CPR Quality Improvement Tool Kit based upon AHA Scientific Advisory Statement; specific and continuous feedback from actual dispatched call recordings; continuous recognition and celebration programs for best outcomes by dispatchers from model calls; and finally, incremental media and public education that will be incorporated throughout the initiative.
There will also be active data collection, which will include before and after controls and require a minimum of six months of historical EMS dispatch and CARES/PAROS data. The data will be used to actively measure primary outcomes, including OHCA survival rates, hospital discharge, and favorable neurological outcomes and secondary outcomes.
Partners:
Bentley J. Bobrow
Brian McNally
Catherine Eden
Marc Chambers
Will Humble
Jonathan Koppell
Bob Khan
American Heart Association
Pan Asian Resuscitation Outcome Study (PAROS)
Medtronic Foundation
ZOLL Medical Corp (Japan)
Laerdal Foundation
University of Arizona, College of Medicine
As taken from Clinton Global Initiative
In every instance of Out of Hospital Cardiac Arrest (OHCA), rates of survival decline precipitously for each minute in which CPR is not performed. This presents a broad public health concerns and also creates substantial health costs.
The Collaborative efforts of the Ramsey Social Justice Foundation along with other EMS providers to improve dispatch-assisted CPR training and implementation in the state of Arizona has resulted in a tripling of the survival rate since 2004. This commitment will seek similar survival rate improvements around the world.
APPROACH
The goal of this three-year global healthcare initiative is to utilize strong international collaborations to efficiently implement dispatch-assisted CPR and to measure this intervention's impact on survival across 10 countries. The initiative's 'Bundle of Care' consists of new advanced evidence-based protocols and procedures, which will include scenario and video training of dispatchers; activation of real-time feedback measures; implementation of event debriefing; continuous data collection and measurement; and finally, the celebration of target successes.
The setting of this initiative will be the Pan-Asian Resuscitation Outcomes Study (PAROS) and the Cardiac Arrest Registry to Enhance Survival (CARES)
The PAROS network was established in 2010 as an international, multi-centre, prospective registry of OHCA across the Asia-Pacific, to date representing a population base of 89 million in 9 countries. It promotes collaboration by bringing together like-minded individuals to share experiences and develop joint initiatives for the betterment of Pre-hospital and Emergency Care (PEC). As a first step, PAROS has identified OHCA as one of its primary interests. The Network will gather valuable information on OHCA and deepen the understanding of the EMS systems in the region to devise strategies that improve survival.
In 2005, CARES began in the metropolitan Atlanta area. The following year, the program expanded to include 6 more cities. In 2011, 40 communities in 25 states and the District of Columbia were participating. CDC plans to expand the program to more areas as interest in CARES grows. In 2010, CARES began an expansion to statewide surveillance in Arizona, Hawaii, Minnesota, North Carolina, Pennsylvania, and Washington.
ACTION PLAN
This action plan consists of two levels of implementation:
The first stage will include implementation of dispatcher CPR training programs and protocols, including a standardized dispatcher-assisted CPR protocol, that were developed by Bentley J. Bobrow, MD, Arizona State Medical Director, Ramsey Community Services Foundation Medical Director and current Chairman of the American Heart Association Basic Life Support Subcommittee. It will also include a training video created in conjunction with the Ramsey Social Justice Foundation and Laerdal Medical. In addition, there will be a one-hour interactive web-based instructional video that will be based upon AHA Guidelines that were finalized in February 2013.
The next implementation level will include the introduction of dispatcher CPR training programs and protocols with six focus areas: an interactive website with updated training information; a one-day intensive dispatch training academy; a Dispatch CPR Quality Improvement Tool Kit based upon AHA Scientific Advisory Statement; specific and continuous feedback from actual dispatched call recordings; continuous recognition and celebration programs for best outcomes by dispatchers from model calls; and finally, incremental media and public education that will be incorporated throughout the initiative.
There will also be active data collection, which will include before and after controls and require a minimum of six months of historical EMS dispatch and CARES/PAROS data. The data will be used to actively measure primary outcomes, including OHCA survival rates, hospital discharge, and favorable neurological outcomes and secondary outcomes.
Partners:
Bentley J. Bobrow
Brian McNally
Catherine Eden
Marc Chambers
Will Humble
Jonathan Koppell
Bob Khan
American Heart Association
Pan Asian Resuscitation Outcome Study (PAROS)
Medtronic Foundation
ZOLL Medical Corp (Japan)
Laerdal Foundation
University of Arizona, College of Medicine
As taken from Clinton Global Initiative
