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(Ivanhoe Newswire) -- Cardiac arrest strikes 166,000 Americans each year. When a victims heart stops beating, there are plenty of ways that bystanders and EMS crews can get it started again. But if those efforts fail and the patient doesnt respond, when should such efforts stop?
This question leads to EMS teams and hospital ER teams spending countless hours and healthcare resources on patients who have no chance of surviving. Often times this happens at the expense of other patients who need an ambulance or have spent hours in ER waiting rooms.
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Now, researchers from the University of Michigan Health System, Emory University and the Henry Ford Health System have come up with simple guidelines to determine when efforts to revive an unresponsive cardiac arrest patient should be terminated. The guidelines were tested using data from more than 5,000 cardiac arrest patients treated in eight metropolitan areas in a study funded by the Centers for Disease Control and Prevention.
The guidelines can be used as a three-part rule or a five-part rule. The three-part rule, called a basic life support or BLS rule, calls for EMS teams to stop their resuscitation efforts if cardiac arrest occurred before EMS arrived, if no defibrillator was used and if the team cant get the patients blood to begin circulating again. The five-part rule, called the advanced life support or ALS rule, adds two more criteria -- the cardiac arrest had no witnesses at all and no bystander at attempted to perform CPR.
Currently, EMS systems vary widely in the care they deliver to cardiac arrest patients. To implement the BLS rule more widely would standardize the care and transport of these patients, so that we can reduce the risk of injuries or death to EMS personnel and the public in high speed transports, decrease the pressure on our overcrowded ERs, allow our ER staff to focus on patients who can be treated, and open up intensive care unit beds, Comilla Sasson, M.D., M.S., the studys lead author, was quoted as saying.
SOURCE: The Journal of the American Medical Association, 2008;300:1432-1438
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