Data Reporting & Implementation of National Standards to Improve Survival
Routine data collection and continuous assessment of treatment outcomes has improved patient care across many diseases and conditions, but there is no national regulatory system for data collection for cardiac arrest events. Unlike hospital-acquired infections, myocardial infarctions, some surgical procedures, and many other medical conditions, the incidence and survival or brain injury outcomes following cardiac arrest treatment are not mandatorily reported. The existing databases for collecting cardiac arrest incidence and outcome data are voluntary, participation varies, and the lack of a single standard for data collection limit the utility of the information collected.
The American Heart Association sets guidelines for cardiac arrest treatment in the United States, and a limited number of hospitals and healthcare systems comply with these guidelines voluntarily as well. Adherence to the full spectrum of these guidelines, as well as implementation of medical strategies based on new emerging evidence from the medical literature regarding monitoring of physiologic parameters during CPR to assess the quality of resuscitation, consideration of advanced techniques such as extracorporeal membrane oxygenation (ECMO) in select cases, and use of mechanical-assist devices in some instances, is varied. The reasons for this range from a lack of resources to gaps in training or awareness about approaches that can maximize the chances for patient survival. The end result is that implementation of the highest standards of resuscitation possible for each patient’s unique circumstances is not always feasible due to a myriad of complex issues.
Since currently almost 75 percent of people whose hearts are restarted after CPR die within hours to days, one of the most important medical interventions that can improve survival and reduce brain injuries is the provision of standardized post-cardiac arrest care in the intensive care unit immediately after the heart starts.