cardiac arrest survival - psow
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Cardiac Arrest Survival - PSOWTRANSCRIPT
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Cardiac Arrest SurvivalJosh Finke
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Disclaimer
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Facts on Sudden Cardiac Arrest
•Approximately 359,400 out of hospital cardiac arrests annually
•90.5% mortality rate=325,257 deaths
•This would equal the death toll of the titanic sinking 4 times every week
• *Data according to AHA
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We Can Do Better!!!
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How can we Improve
•CCR
•Automated Compression Devices
•Team Approach
•Capnography
•Data
•Pre Arrival CPR
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Importance of Data
•Is what we are doing working?
•Are we spending money where it should be spent?
•Do we really make a difference?
•Does staffing matter?
•Does getting there one minute faster really help?
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How to Keep Cardiac Arrest
Data•Wausau Fire has maintained
cardiac arrest data since 2012
•The CARES data set is used
•The only person that sees it is me!!!
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Changes in Our Cardiac Arrest
Protocols•CPR to CCR
•Change from Combi to King for backup airway
•Addition of automated compression device after trial
•Addition of induced Hypothermia
•Addition of capnography
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Capnography????
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Automated Compression Device
**During a trial an increase to out of hospital survival of 6% was found
with the use of a compression device**
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Some of our Data
•In 2010/2011 the approximate cardiac arrest survival rate was 12%-18%
•In 2012 after protocol changes and equipment upgrades our overall survival rate was 33%; of those 93% had a CPC score of 1 or 2.
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Maybe it was Just a Lucky Year???
•In 2013 the overall survival rate was 26%; of those 100% had a positive neurological outcome!!
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•2012
•42 total arrests
•13 VF/VT
•8 VF/VT ROSC=61.5% (all survived)
•29 PEA/Asystole
•7 PEA/Asystole ROSC=24% (3 survived)
Lets be more Specific
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•2013
•34 total arrests
•7 VF/VT
•4 VF/VT ROSC=57% (all survived)
•27 PEA/Asystole
•7 PEA/Asystole ROSC=26% (4 survived)
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•2014 (Jan-Jun)
•17 total arrests
•3 VF/VT
•3 VF/VT ROSC=100% (2 survived 66%)
•14 PEA/Asystole
•1 PEA/Asystole ROSC=7% (1 survived) 100%)
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•Total VF/VT arrests 2012-2014=23
•Total VF/VT ROSC=15 (65%)
•Total PEA Asystole Arrests=70
•Total PEA/Asystole ROSC=15 (21%)
•VF/VT survival to discharge 61%
•Asystole/PEA survival to discharge 11%
The Big Picture
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•Overall survival rate 2012-2014=23.6%
•Overall survival 2010-2011=12-18%
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•Use of the CARES data set
•Using 52 data points
•Great data but very underused
Data Tracking
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Data Bank•Statewide cardiac arrest data bank
•Each service data submitted quarterly
•All data would be complied and returned to each participating service
•Service names would be kept confidential
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Benefits
•A larger pool of data
•Ability to determine what works and what doesn't without trying it for yourself
•Ability to increase cardiac arrest survival across Wisconsin
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Possibilities
•Normal cardiac arrest ratio 1 for every 1,000 population annually
•Wisconsin population=5,726,000 or approximately 5,726 cardiac arrests statewide
•90% mortality rate=5,153 deaths
•76% mortality rate=4,351 deaths
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•Over 800 more lives saved!!!
•This would be equal to saving the entire Village of Crystal Lake WI every year
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I’m on the Trail of Better Outcomes
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Contact [email protected]