Bystander CPR, Living Wills & Online Forums

Chris P. Kaiser, Editor

The cardiovascular community has galvanized its resources in the last several years to improve morbidity and mortality associated with sudden cardiac arrest. Door-to-balloon times have been reduced and care during transport and in the hospital has become more standardized than in the past. But a large part of improved survival is due to the efforts of communities to educate its members about the value of CPR and automated external defibrillators (AEDs).

Our top story this month validates smaller studies that promote the value of performing PCI on resuscitated arrest patients, despite their neurological condition. Interestingly, though, toward the end of the study, the authors praised a local program in Delaware designed to train bystanders in CPR and AED use, suggesting that the high rate of survival in witnessed arrests is due to the high rate of bystander involvement in performing life-saving CPR.

In another area of concern, it seems that emergency medical technicians (EMTs) could be better educated regarding the difference between living wills and do-not-resuscitate (DNR) orders. In one of our featured stories, researchers found an alarming rate of confusion in EMTs and paramedics regarding how living wills are interpreted.

Besides the obvious need to better educate EMTs and paramedics, investigators provide a simple solution for people so their living wills are not misconstrued. Perhaps it would behoove those in cardiovascular medicine to also educate patients who are at risk of sudden cardiac arrest on the nuances of living wills versus DNRs, so they receive the appropriate treatment following an arrest in the field.

Physicians and allied health professionals can help patients better educate themselves on cardiac arrest by referring them to our second top story on the Sudden Cardiac Arrest Association, an online community started by sudden cardiac arrest survivors, with expert commentary from physicians, nurses and hospital administrators.

We are at a crossroads in our treatment of sudden cardiac arrest and one of the major factors ensuring success is the ability of caregivers and communities to coordinate their efforts with various people along the continuum of care. As more of these efforts become public, we will be covering them in our External Defibrillator Portal.

If you have any comments on these or any other topics, please feel free to send me an email.

Thank you.

Chris P. Kaiser, Editor
ckaiser@cardiovascularbusiness.com