The public were found to estimate survival rates following CPR at over 50%, whereas survival to discharge is actually less than 10% for out-of-hospital arrests and 10–20% for in hospital arrests. It is likely that the majority of perceptions are formed through the portrayal of resuscitation in fictional medical dramas, researchers say.

Mr Field said: “Public perception of outcome following a cardiac arrest is very important as it has the potential to influence the motivation for learning and performing CPR as well as making and/or supporting do not attempt cardiopulmonary resuscitation (DNACPR) decisions”.

The Resuscitation Council (UK), which funded the study, advocates a joint approach to DNACPR decision-making. This can involve both the patient, or those close to the patient and the clinical team. They emphasise the importance of accurate public perception regarding cardiac arrest survival, to ensure correct decisions are made and expectations are realistic.

Resuscitations in a public place and involving heroic bystander CPR attempts are more likely to attract the media looking for high-impact news stories, the authors suggest.  In reality around 70% of cardiac arrests occur at home and only 36% of these patients will receive bystander CPR, compared with bystander CPR performed in 75% of events occurring in a public place.

References

1 Field RA, Soar J, Nolan JP, Perkins GD. Epidemiology and outcome of cardiac arrests reported in the lay-press: an observational study.  J R Soc Med. 2011;104:525—31. doi:10.1258/jrsm.2011.110228.

Defibshop.co.uk project manager Gina Harris said: “We believe as manufacturers, distributors and trainers that defibrillators are incredibly important pieces of equipment, particularly if you look at the statistics, where 12 young children die every week from sudden cardiac arrest”.

“We believe that the Hand on Heart campaign is a very powerful way of raising awareness to the problem of cardiac arrest in the young but also a way of doing something positive about it by providing life saving solutions into schools.”

Defibshop.co.uk project manager Gina Harris

“If you have to wait for an ambulance it maybe too late whereas if you have a defibrillator and are able to use it, the victim’s chance of survival leaps to approximately 78 per cent chance of survival -  that is certainly money and time well invested.”

Schools can apply for a grant for a free device, or partner with a local business to support their application – Manchester City Football Club has joined the programme recently, nominating the North East Manchester Academy for selection.

Sales manager Paula Leech said: “Due to a lack of screening in young people fatal heart conditions are not diagnosed until they go into cardiac arrest. Our key objective is to educate and equip staff and pupils with the knowledge and skills to save a life”.

For further information visit: www.handonheart.org

After adjustment for other factors, in VF/VT patients, hypothermia was associated with increased odds of good neurological outcome (adjusted odds ratio, 1.90; 95% confidence interval, 1.18 to 3.06) but not in PEA/asystole patients (adjusted odds ratio, 0.71; 95% confidence interval, 0.37 to 1.36). The study’s authors recommend further investigation into the implications of this discrepancy.

While therapeutic hypothermia has been shown to considerably improve outcomes for patients at risk of ischaemic tissue damage, a drawback of the technique is that it provokes the body’s natural response to potentially dangerous reduction in temperature. Shivering, a defense mechanism against cooling, produces more body heat and increases overall metabolic activity, dramatically increasing oxygen demand and consumption.

This can have deleterious effects for patients who have suffered a global ischaemic event. In order to overcome this increase in metabolic heat the physician must usually paralyze a patient to eliminate shivering, unless the cooling system is specifically designed to quickly get below the shivering threshold.

Advancement in the therapeutic uses of induced hypothermia were the focus of an announcement published recently in the International Journal of Stroke. The report outlines the findings and objectives laid out by the European Hypothermia Stroke Research Workshop, held in January 2010, which was organised by the European Stroke Research Network for Hypothermia (EuroHyp) and attended by representatives of the World Stroke Organisation, European Stroke Organisation, and the European Space Agency.

We will feature more news and reviews on therapeutic hypothermia in the future.

Reference

1. Dumas F, Grimaldi D, ZuberIs B et al. Hypothermia After Cardiac Arrest Effective in Both Shockable and Nonshockable Patients? Insights From a Large Registry. Circulation 2011, doi: 10.1161/CIRCULATIONAHA.110.987347
2. Macleod MR, Petersson J, Norrving B et al. Hypothermia for Stroke: call to action 2010. International Journal of Stroke 2010;5:489–92

Marie-Noelle Orzel, Patient Safety First’s deterioration intervention lead and Director of Nursing & Patient Care at Royal Devon & Exeter Foundation Trust says:  “Having clear data is central to being able to make and measure improvements to patients at risk of deterioration and cardiac arrest.  Trusts can determine how to improve safety for their patients by understanding where, when and what type of calls happen, whether they happen to particular patient groups and the reasons why a call is required.”

Patient Safety First provides a practical five-step approach for how trusts can monitor the types of cardiac arrest calls they have: The five steps to ‘Count your calls’ are:

• Where are your cardiac arrest calls or cardiac arrests coming from? This helps to identify potential ‘hotspots’ within the hospital that need targeted work.
• When are your cardiac arrest calls or cardiac arrests occurring? This will help to identify if there are certain days or times that are a specific problem, for example at night or at the weekend.
• Who are the individual patients needing cardiac arrest calls? Are there particular patient groups with high levels of calls or deaths associated with cardiac arrest? Identifying and collecting key  demographic data helps build a picture of any particular patient groups that are associated with calls.
• What happened? What type of call or cardiac arrest was it? What was the immediate outcome? This helps to identify the type of cardiac arrest call or type of cardiac arrest and provides data on the immediate outcome.
• Why was a cardiac arrest call required? This helps to determine whether a cardiac arrest call or cardiac arrest is predictable or unpredictable. Potentially predictable calls can be further classified as preventable or unpreventable.

Patient Safety First is encouraging trusts to take advantage of the range of online resources and tools designed to help them make improvements at a local level – www.patientsafetyfirst.nhs.uk.

‘Count your calls’  is the first of four Patient Safety First focus weeks that will provide trusts with an opportunity to explore their patient safety issues and join online discussions with experts.

The focus weeks include:

• 18^th January – Focus on Deterioration : ‘Count your calls’
• 1^st February – Focus on Human Factors in healthcare
• 1^st March – Focus on Ventilator care bundles: stories of improvement
• 8^th March – Focus on Insulin: ‘Testing a new care bundle for Insulin prescribing’.

For more information visit www.patientsafetyfirst.nhs.uk