Establishing Arizona's Statewide Cardiac Arrest Reporting andEducational Network

Abstract

Background. Only a few large cities have published their out-of-hospital cardiac arrest (OHCA) survival statistics using the Utstein style reporting method. To date, to the best of our knowledge there has been no published OHCA survival data for a state. Objective. To describe the process, benefits, andchallenges of establishing a statewide OHCA database andeducational network. Methods. Arizona's Bureau of Emergency Medical Services andTrauma System initiated a statewide, prospective, observational cohort review of all OHCA victims on whom resuscitation was attempted in the field. Emergency medical services (EMS) first care reports, voluntarily submitted by 35 departments in Arizona, were analyzed. We chronicled the development of our data-collection process along with how we obtained patient outcomes anddelivered feedback to field providers. Entry data included time intervals andnodal events conforming to the Utstein style template. Results. In data collected between January 1, 2005, andApril 1, 2006, there were 1,484 OHCAs reported, of which 1,104 were of presumed cardiac etiology occurring prior to EMS arrival. The OHCA incidence was approximately 0.44 per 1,000 population per year. In our database, bystander CPR provided an odds ratio of 3.0 for survival (95% confidence interval 1.3, 6.7). Outcomes for 1,076 patients were obtained. Thirty-seven (3.4%) of the 1,076 cardiac arrest victims survived to hospital discharge. Twenty-seven (8.6%) of the 331 ventricular fibrillation cardiac arrest victims survived to hospital discharge. Conclusion. It is feasible for a public health agency to implement a voluntary, statewide data-collection system andeducational network to determine andimprove survival from OHCA.

Key words:

• CPR
• cardiac arrest
• Utstein style reporting
• EMS systems