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Regional cardiac resuscitation systems of care
1Medic One Foundation, Harborview Center for Prehospital Emergency Care Medical Director University of Washington Clinical Trials Center Division of General Internal Medicine Harborview Medical Center
*Corresponding Author(s): NICHOL GRAHAM E-mail: grahamnichol@spamarrest.com
Out-of-hospital cardiac arrest (OOHCA) is a common public health problem, with large and important regional variations in outcomes. Survival rates vary widely among patients treated with OOHCA by emergency medical services (EMS), or among patients transported to the hospital after return of spontaneous circulation. Most regions lack a well-coordinated approach to post–cardiac arrest care. Effective hospital-based interventions for OOHCA exist but are used infrequently. Increased volume of patients or procedures of individual providers and hospitals is associated with better outcomes for several other clinical disorders. Regional systems of cardiac resuscitation include a process for identification of patients with OOHCA, standard field and hospital care protocols for patients with OOHCA, monitoring of care processes and out-come, and periodic review and feedback of these quality improvement data to identify problems and implement solutions. Similar systems have improved provider experience and patient outcomes for those with ST-elevation myocardial infarction and life-threatening traumatic injury. Many more people could survive OOHCA if regional systems of cardiac resuscitation were implemented and maintained. The time has come to do so wherever feasible.
out-of-hospital cardiac arrest, emergency medical serv-ices, hospital-based interventions, regional systems of cardiopulmo-nary resuscitation (CPR), monitoring, outcome, transport time, improve of quality, survival
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