Minnesota Resuscitation Consortium
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1 Minnesota Resuscitation Consortium Dedicated to reducing deaths due to cardiac arrest in all of Minnesota How will we benchmark our success? What means will we pursue to reach this goal? American Heart Association 2010 Guidelines Google images Five fundamentals in Chain of Survival Early recognition and activation Early CPR Early defibrillation Effective advanced life support Integrated post-cardiac arrest care Has saved hundreds of thousands of lives around the world. Systems Based Approach Bystander CPR Lay Public First AED ICD Survival ITD Hospital EMS Angiography Automated CPR Hypothermia IO 1
2 Without systems based approach No mother No baby 4 With systems based approach Mother and Serenity Joy: 15 months old, status post in utero Take Heart MN CPR Minnesota Resuscitation Consortium 1. Benchmarking DATA DATA DATA CARES for all of Minnesota 2
3 Utstein Style of Survival Reporting 1990 conference Utstein Abbey at Mosterøy, Norway. What s your Utstein number Utstein Hennepin/National Survival Report Bystander Intervention (411) National AED % 1.7 (7) 1.5% CPR % 15.6 (64) 22.6% Cardiac etiology survival rates Overall: 16.5 % (462) 10.4% Bystander wit d: 28% (182) 17.1% Utstein: 49.4% (89) 31.8% Utstein bystander: 51.4% (35) 34.7% EMS witnessed: 27.5% (51) 19.0% Unwitnessed: 4.8% (229) 4.2% Shockable / bystand: 48.9% (182) 38.0% 3
4 Utstein Hennepin/National Survival Report Bystander Intervention (411) National AED % 1.7 (7) 1.5% CPR % 15.6 (64) 22.6% Cardiac etiology survival rates Overall: 16.5 % (462) 10.4% Bystander wit d: 28% (182) 17.1% Utstein: 49.4% (89) 31.8% Utstein bystander: 51.4% (35) 34.7% EMS witnessed: 27.5% (51) 19.0% Unwitnessed: 4.8% (229) 4.2% Shockable / bystand: 48.9% (182) 38.0% CARES Agency National Number of survivors CARES Agency Number of survivors
5 Hennepin County Bystander CPR only 16% nationally 23% Utstein Hennepin/National Survival Report Bystander Intervention (411) National AED % 1.7 (7) 1.5% CPR % 15.6 (64) 22.6% Cardiac etiology survival rates Overall: 16.5 % (462) 10.4% Bystander wit d: 28% (182) 17.1% Utstein: 49.4% (89) 31.8% Utstein bystander: 51.4% (35) 34.7% EMS witnessed: 27.5% (51) 19.0% Unwitnessed: 4.8% (229) 4.2% Shockable / bystand: 48.9% (182) 38.0% 5
6 Minnesota Resuscitation Consortium 2. Increase the percentage of SCA victims who receive effective bystander CPR. Dispatcher instructed Hands only CPR Teach CPR Anytime Hennepin County Bystander AED use 1.7% nationally 1.5% Utstein Hennepin/National Survival Report Bystander Intervention (411) National AED % 1.7 (7) 1.5% CPR % 15.6 (64) 22.6% Cardiac etiology survival rates Overall: 16.5 % (462) 10.4% Bystander wit d: 28% (182) 17.1% Utstein: 49.4% (89) 31.8% Utstein bystander: 51.4% (35) 34.7% EMS witnessed: 27.5% (51) 19.0% Unwitnessed: 4.8% (229) 4.2% Shockable / bystand: 48.9% (182) 38.0% 6
7 Minnesota Resuscitation Consortium 4. Increase the percentage of SCA victims who receive rapid defibrillation with an AED. EMS/Community grants TABLE 2. Demographic and Survival Characteristics of OHCA January 1, 2010 December 31, 2010* Characteristic Hennepin County Group Report (N=462) NATIONAL (N=11,982) Age N=462 N=11980 Mean (SD) 64.6 (18.4) 64.4 (18.2) Median Gender (%) N=462 N=11979 Female 171 (37.0) 4535 (37.9) Male 291 (63.0) 7444 (62.1) Race (%) N=461 N=11970 American Indian/Alaskan 9 (2.0) 64 (0.5) Asian 5 (1.1) 169 (1.4) Black/African American 28 (6.1) 3015 (25.2) Hispanic/Latino 2 (0.4) 603 (5.1) Native American/Pacific Islander 0 (0) 89 (0.7) White 147 (31.9) 4654 (38.9) Unknown 270 (58.6) 3376 (28.2) Location of Arrest (%) N=462 N=11982 Educational Institution 1 (0.2) 25 (0.2) Farm 1 (0.2) 3 (0.03) Healthcare Facility 4 (0.9) 240 (2.0) Home/Residence 308 (66.7) 8018 (66.9) Hospital 0 (0) 46 (0.4) Industrial Place 3 (0.7) 56 (0.5) Jail 0 (0) 44 (0.4) Nursing Home 47 (10.2) 1554 (13.0) Other 6 (1.3) 345 (2.9) Place of Recreation 5 (1.1) 159 (1.3) Public/Commercial Building 40 (8.7) 716 (6.0) Residence/Institution 11 (2.4) 161 (1.3) Street/Highway 35 (7.6) 561 (4.7) Transport Center 1 (0.2) 54 (0.4) 7
8 Type of Initial Rhythm (%) N=462 N=11948 Vfib/Vtach 62 (13.4) 2268 (19.0) Asystole 129 (27.9) 5294 (44.3) Idioventricular/PEA 72 (15.6) 2396 (20.0) Unknown Shockable Rhythm 76 (16.5) 620 (5.2) Unknown Unshockable Rhythm 123 (26.6) 1370 (11.5) Arrest witnessed (%) N=462 N=11982 No 229 (49.6) 6429 (53.7) Yes 233 (50.4) 5553 (46.3) Arrest after arrival of EMS or FR? (%) N=462 N=11982 No 411 (89.0) (89.4) Yes 51 (11.0) 1274 (10.6) Who initiated CPR (%) N=462 N=11980 Not Applicable 2 (0.4) 13 (0.1) Total Bystanders (LP+LPFM+LPMP)** 111 (24.0) 3929 (32.8) First Responder 259 (56.1) 4466 (37.3) Emergency Medical Services (EMS) 90 (19.5) 3572 (29.8) Who first applied automated external defibrillator (%) N=461 N=11976 Not Applicable 1 (0.2) 39 (0.3) Total Bystanders (LP+LPFM+LPMP)** 12 (2.6) 487 (4.1) First Responder 243 (52.7) 4545 (37.9) Emergency Medical Services (EMS) 205 (44.5) 6905 (57.7) Return of Spontaneous Circulation in Field (%) N=462 N=11978 No 268 (58.0) 7587 (63.3) Yes 194 (42.0) 4391 (36.7) Pre hospital Outcome (%) N=462 N=11982 Dead in Field 187 (40.5) 3068 (25.6) Ongoing Resuscitation in ED 247 (53.5) 6640 (55.4) Pronounced in ED 28 (6.1) 2274 (19.0) 8
9 Overall Survival (%) N=462 N=11982 Overall Survival to Hospital Admission 161 (34.9) 3321 (27.7) Overall Survival to Hospital Discharge 76 (16.5) 1246 (10.4) With Good or Moderate Cerebral Performance 70 (15.2) 937 (7.8) Utstein Survival (%) N=89 N=1631 Witnessed by bystander and found in shockable rhythm Utstein Bystander Survival (%) N=35 N= Witnessed by bystander, found in shockable rhythm, and received some bystander intervention (CPR by bystander and/or AED applied by bystander) *Excludes unworked arrests and arrests of non cardiac etiology **Total Bystanders (LP+LPFM+LPMP): LP=layperson; LPFM=layperson family member; LPMP=layperson medical provider Greg was a little shaky and unsure at first, but after passing his EP Boards this past year he is back in the saddle and doing great 9
10 Utstein Hennepin/National Survival Report Bystander Intervention (411) National AED % 1.7 (7) 1.5% CPR % 15.6 (64) 22.6% Cardiac etiology survival rates Overall: 16.5 % (462) 10.4% Bystander wit d: 28% (182) 17.1% Utstein: 49.4% (89) 31.8% Utstein bystander: 51.4% (35) 34.7% EMS witnessed: 27.5% (51) 19.0% Unwitnessed: 4.8% (229) 4.2% Shockable / bystand: 48.9% (182) 38.0% 10
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