Cardiac Arrest SurvivalJosh Finke

Disclaimer

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

We Can Do Better!!!

How can we Improve

•CCR

•Automated Compression Devices

•Team Approach

•Capnography

•Data

•Pre Arrival CPR

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?

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!!!

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

Capnography????

Automated Compression Device

**During a trial an increase to out of hospital survival of 6% was found

with the use of a compression device**

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.

Maybe it was Just a Lucky Year???

•In 2013 the overall survival rate was 26%; of those 100% had a positive neurological outcome!!

•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

•2013

•34 total arrests

•7 VF/VT

•4 VF/VT ROSC=57% (all survived)

•27 PEA/Asystole

•7 PEA/Asystole ROSC=26% (4 survived)

•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%)

•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

•Overall survival rate 2012-2014=23.6%

•Overall survival 2010-2011=12-18%

•Use of the CARES data set

•Using 52 data points

•Great data but very underused

Data Tracking

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

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

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

•Over 800 more lives saved!!!

•This would be equal to saving the entire Village of Crystal Lake WI every year

I’m on the Trail of Better Outcomes

Contact Infojoshua.finke@ci.wausau.wi.us