Better numbers needed to cut heart attack deaths
If you have a cardiac arrest whether you live or die depends largely on where you live.
If you live in Seattle, for example, you have about a 50/50 chance of surviving.
But if you live in Dallas, Texas, your chances are 1 in 10. In New York City, they’re 1 in 20.
And if you live in Detroit, your chances are about zero.
The reason why the chances of a Seattleite are so much better is that the city has invested in education programs that have trained large numbers of people in CPR (CardioPulmonary Resuscitation) and has developed emergency services that get resuscitation teams to the scene within minutes.
In this week’s issue of JAMA, the Journal of the American Medical Association, University of Washington School of Medicine professors Dr. Mickey S. Eisenberg and Dr Bruce M. Psaty, argue that to save more lives the federal government should start tracking the survival rates of cardiac arrest victims nationwide.
They note that since 1990, fewer than 24 U.S. communities have reported their survival rates for ventricular fibrillation (VF), a heart rhythm that prevents the heart from pumping blood and that is the most common cause of death from cardiac arrest.
If every community collected their survival rates, medical directors of emergency services will be able to see how well their systems are doing and identify ways to improve their performance, Dr. Eisenberg and Dr. Psaty write.
“Whenever a patient who was expected to live dies, the appropriate question is why,” Eisenberg and Psaty write. “This approach is as appropriate for VF as it is for any other unexpected adverse medical outcome. A large proportion of patients with VF should survive; and if they do not, the questions “Why did this patient die? What could have been done to save this life?” should be asked.”
Currently, the government collects and reports far more information about the state of the economy that it does about the health of the public, they write, and what collection is done is often sporadic and unsystematic.
Setting up an agency within the U.S. Department of Health and Human Services to track the quality of prehospital and emergency care would be a good first step to improving this situation, they write, and cardiac arrest survival rates would be a good place to start: first because CPR and quick defibrillation have been shown to be effective and, second, because, unlike some health statistics that tend to seem vague, people saved by emergency medical systems are “individually identifiable as neighbors, friends, and family members.”
To learn more:
- Read the article ?Defining and improving survival rates from cardiac arrest in US communities” by Dr. Eisenberg and Dr. Psaty in JAMA (fee or subscription may be required).
- Visit King County Medic One’s Web site.
- Visit the Web site of King County’s Emergency Medical Services, which has links to CPR instruction and other courses.
Category: Emergency Medicine, Health-care Policy, Heart & Circulation, University of Washington
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