Cardiopulmonary resuscitation

National Quality Registry for Cardiopulmonary Resuscitation

Contents

The Swedish CPR Registry describes cardiac arrest treated both within and outside of the hospital. Data reported at hospitals is registered by staff at the hospital. Data reported outside hospitals is registered by paramedic (EMC) staff. The registry also describes the Swedish heart start and CPR training registries. Follow-up of the patients who have survived cardiac arrest are described in terms of patient-reported outcome measures (PROM). A description is also provided of the use of registry data in research.

Background

A large percentage of the people who die due to heart disease die before arrival at the hospital due to sudden and unexpected cardiac arrest. People with acute heart disease who are alive upon arrival at the hospital have the benefit of advanced care resources and enormous knowledge and experience on how to reduce the risk of death.

A large percentage of people who die of heart disease suffer from a sudden “electrical chaos” in the heart, ventricular fibrillation, leading to cardiac arrest. If adequate equipment and staff were on the scene, a large percentage of lives could likely be saved. Every minute that passes before help arrives, however, reduces the chances of survival. After only five minutes, the body begins suffering irreparable damage due to lack of oxygen resulting from cardiac arrest. After about fifteen minutes, death is almost inevitable no matter what emergency measures are initiated.

The main treatment for most of these people is an electric shock to the heart using a defibrillator. One or more such shocks can return the heart to normal function. The only way to get a defibrillator to a patient in Sweden in the past was via ambulance transport. Over the past twenty-five years, there has been a rapid development in emergency medical services and today all vehicles carry defibrillators. However, in most cases the period of time from the cardiac arrest to the provision of electrical treatment is too long for the patient to survive. It is therefore necessary to create opportunities for earlier defibrillation treatment through organisational measures.

The likelihood of surviving cardiac arrest increases dramatically if the person’s breathing and circulation is artificially maintained while waiting for the ambulance to arrive. There is a simple method of achieving this – cardiopulmonary respiration (CPR) – which involves alternating chest compressions to maintain circulation and providing mouth-to-mouth resuscitation by blowing air into the lungs. To increase the chances of survival for a person who has suffered a cardiac arrest, there must be someone present who has learned CPR and is willing to apply their knowledge.

For CLP to have any real significance in cardiac arrest survival, a very wide dissemination of training is required, preferably focused on persons who are most likely to be present during an acute heart attack leading to cardiac arrest. For nearly thirty years, a very effective training programme has trained almost three million people in CPR. This means there is now the possibility for people with heart disease to survive a cardiac arrest outside the hospital. There has, however, previously been almost a total lack of knowledge in Sweden about this group of patients in terms of personal characteristics, location of cardiac arrest, how they are cared for when the cardiac arrest occurs, and in particular, the effect of treatment on survival.

Cardiac arrest does not only affect persons with heart disease. There are other patient groups who are affected for other reasons, such as in connection with asthma attacks, traffic accidents or near-drownings. Even in these cases, fast response can prevent a cardiac arrest from becoming fatal. Data is also lacking for these groups of persons concerning to what extent modern treatment can prevent fatalities.

Aims

• Identify the population affected and the circumstances surrounding the cardiac arrest.
• Provide a detailed description of the time lapse and treatment outside the hospital.
• Register the effects of treatment in the form of short- and long-term survival.
• Through an annual compilation of data and feedback to participating ambulance districts, create a stimulus for continuous improvements in treatment methods and organisations.
• Through a national registry, create sufficiently great patient data to identify the best treatment methods and communicate this information to participating ambulance districts.

Contact information

Find contact information on the registry’s website.