Posted by Bob Trenkamp on 08/24/2011

In no particular order, here are some punctuation marks from the CARES data for the past 4+ years.

By way of background, there are two significant categories of heart rhythm: shockable and un-shockable. The first chance we have of learning what a cardiac arrest victim's heart rhythm is occurs when an AED or cardiac monitor is first attached to the victim.

The length of time that passes between the victim's death and the attachment of a monitor / AED is extremely important because there is frequently a progression from one rhythm to another over time when someone arrests. For example, a victim might begin in a shockable rhythm when they died, and with the passage of a few minutes, they might have transitioned into an un-shockable rhythm.

The CARES data show that in fewer than 4% of the cases, the AED or Cardiac Monitor was attached by a bystander. In the rest of the cases, it was the EMT who did the attaching. There are two major possibilities for the delay: either there was no AED nearby, or the bystanders waited for the EMTs to attach their Cardiac Monitor. Either way, it's likely that more than 96% of the victims did not receive timely application of the AED.

With all that as background,

  1. In the recently published CARES data, 23.7% of the cases presented with a shockable rhythm, and 76.3% presented with an un-shockable rhythm. Of all the survivors, two-thirds were from the shockable population and one-third were from the un-shockable population. Put another way, 27.1% of the shockable population survived, and 4.2% of the un-shockable population survived.
  2. THIS UNDERSCORES THE IMPORTANCE OF BEING ABLE TO GET AN AED ON A CARDIAC ARREST VICTIM WITHIN A MINUTE OR FEW. TO DO THIS, THERE HAVE TO BE PUBLIC ACCESS AEDs WHERE THEY ARE NEEDED.
  3. More than half the arrests were witnessed. About 4% of the victims of unwitnessed arrests survived, and about 16% of the victims of witnessed arrests survived.
  4. Playing a little loose and easy with the numbers for the purpose of sizing the problem, We're currently saving 16% of half the arresting population and 4% of the other half. If all arrests were witnessed, we could save an additional 12%. The data show that 66% of all arrests occurred at home and that the survival rate for those arrests was 7.6%. This gives a whole new meaning to "Home Alone." It also makes one wonder if there wouldn't be some value to a wearable bracelet or other device that would transmit the location of an arrested person, should it detect that the person just became pulseless.
  5. Amplifying the previous observation, if one looks at the Survivor Network data, only 13% of the survivors suffered their cardiac arrests at home.
  6. Airports, Educational Institutions, Public Buildings, Recreation / Sports Facilities and Physicians Offices / Clinics all got between 23% and 28% of their victims back. Farms were at the bottom of the list (0%) on a very small sample size, and Nursing Homes rang up a 3.7% save rate.
  7. The contribution of the SCA Foundation to the Survivors Network and the contribution of the folks at Emory University who have made the CARES project possible is going to fuel accelerated progress over the next few years as we learn more about how to prevent, how to treat, and how to aid survivors. These are exciting times!

Bob

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