![]() Both animal and clinical studies demonstrate that the quality of CPR during resuscitation has a significant impact on survival and contributes to the wide variability of survival noted between and within systems of care. 12 – 14 Survival from cardiac arrest depends on early recognition of the event and immediate activation of the emergency response system, but equally critical is the quality of CPR delivered. To maximize survival from cardiac arrest, the time has come to focus efforts on optimizing the quality of CPR specifically, as well as the performance of resuscitation processes in general.ĬPR is a lifesaving intervention and the cornerstone of resuscitation from cardiac arrest. The variations in performance and survival described in these studies provide the resuscitation community with an incentive to improve outcomes. 10 Similarly, when rescuers compress too slowly, return of spontaneous circulation (ROSC) after in-hospital cardiac arrest falls from 72% to 42%. When rescuers compress at a depth of <38 mm, survival-to-discharge rates after out-of-hospital arrest are reduced by 30%. Patient survival is linked to quality of cardiopulmonary resuscitation (CPR). 9 There is significant variability with regard to location, with 9% survival at night in unmonitored settings compared with nearly 37% survival in operating room/postanesthesia care unit locations during the day. 2 In the United States, >500 000 children and adults experience a cardiac arrest, and 20% if the arrest occurs between the hours of 7 am and 11 pm but only 15% if the arrest occurs between 11 pm and 7 am. 1 Globally, the incidence of out-of-hospital cardiac arrest ranges from 20 to 140 per 100 000 people, and survival ranges from 2% to 11%. Worldwide, there are >135 million cardiovascular deaths each year, and the prevalence of coronary heart disease is increasing. ![]() Clear definitions of metrics and methods to consistently deliver and improve the quality of CPR will narrow the gap between resuscitation science and the victims, both in and out of the hospital, and lay the foundation for further improvements in the future. This consensus statement addresses the following key areas of CPR quality for the trained rescuer: metrics of CPR performance monitoring, feedback, and integration of the patient’s response to CPR team-level logistics to ensure performance of high-quality CPR and continuous quality improvement on provider, team, and systems levels. This ambiguity also impedes the development of optimal systems of care to increase survival from cardiac arrest. Victims often do not receive high-quality CPR because of provider ambiguity in prioritization of resuscitative efforts during an arrest. As such, CPR quality varies widely between systems and locations. Although it is clear that high-quality CPR is the primary component in influencing survival from cardiac arrest, there is considerable variation in monitoring, implementation, and quality improvement. There are 5 critical components of high-quality CPR: minimize interruptions in chest compressions, provide compressions of adequate rate and depth, avoid leaning between compressions, and avoid excessive ventilation. The "2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" increased the focus on methods to ensure that high-quality cardiopulmonary resuscitation (CPR) is performed in all resuscitation attempts. Customer Service and Ordering Information.Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).
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