Improving resuscitation outcomes for out-of hospital Cardiac Arrest

Maaret Castren passionately delivers her take on how to improve outcomes from out-of-hospital cardiac arrests. Maaret brings resuscitation back to the basics. Using science, education and local organisation factored together, we can drastically improve the chance of survival in out-of-hospital cardiac arrest. Currently, the best systems in the world only garner 20% survival rates in these situations. Mareet explains that quite simply, education is lacking. She believes the first step is to know your patient. 50% of cardiac arrest patients have signs and symptoms in the preceding weeks before their arrests. However, there is no current sudden cardiac arrest risk prediction tool available! Maaret explains the concept of precision medicine – the idea that medicine practised in a one size fits all manner provides successful treatments to some patients but not all. One must consider individual differences in people’s genes, environments and lifestyles. In resuscitation medicine this can simply mean altering hand position based on a patient’s size. Developing a culture of excellence is crucial in improving survival rates. Maaret challenges you to make the decision to not allow anyone suffering a cardiac arrest to die. She challenges you to not accept failure – and if it is to occur then to scrutinise why. Maaret goes on to assert that while people have been trained and equipped with skills to deal with a cardiac arrest, health professionals have been found wanting research. Doctors and nurses have been shown to have less survivors when calling emergency numbers. She wants this to improve through ongoing education and training. Currently there is a huge variation in outcomes for cardiac arrest patients. Measuring your results makes it possible for you to know what to improve. Benchmarking shows you where you need to learn. You need to build a culture of excellence in your own system. Patients are not the same, so we need to also individualise resuscitation. Maaret implores you to make the jump from the current culture to the desired culture and in doing so improve the resuscitation outcomes from out-of-hospital cardiac arrests.

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