Dallas, TX , November 28, 2005
We have always known that CPR is not a single skill but a series of assessments and interventions. More recently we have become aware that cardiac arrest is not a single problem and that the steps of CPR may need to vary depending on the type or etiology of the cardiac arrest. At the 2005 Consensus Conference researchers debated all aspects of detection and treatment of cardiac arrest. Yet the last summation returned to the beginning question: how do we get more bystanders and healthcare providers to learn CPR and perform it well?
Sudden cardiac arrest (SCA) is a leading cause of death in the United States and Canada. Although estimates of the annual number of deaths due to out-of-hospital SCA vary widely, data from the Centers for Disease Control and Prevention estimates that in the United States approximately 330,000 people die annually in the out-of-hospital and emergency department settings from coronary heart disease. About 250,000 of these deaths occur in the out-of-hospital setting. The annual incidence of SCA in North America is 70.55 per 1000 population.
CPR is important both before and after shock delivery. When performed immediately after collapse from VF SCA, CPR can double or triple the victim’s chance of survival. CPR should be provided until an automated external defibrillator (AED) or manual defibrillator is available. After about 5 minutes of VF with no treatment, outcome may be better if shock delivery (attempted defibrillation) is preceded by a period of CPR with effective chest compressions that deliver some blood to the coronary arteries and brain. CPR is also important immediately after shock delivery; most victims demonstrate asystole or pulseless electrical activity (PEA) for several minutes after defibrillation. CPR can convert these rhythms to a perfusing rhythm.
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