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(Circulation. 2008;117:704-709.)
© 2008 American Heart Association, Inc.

AHA Scientific Statement

Reducing Barriers for Implementation of Bystander-Initiated Cardiopulmonary Resuscitation

A Scientific Statement From the American Heart Association for Healthcare Providers, Policymakers, and Community Leaders Regarding the Effectiveness of Cardiopulmonary Resuscitation

Benjamin S. Abella, MD, MPhil; Tom P. Aufderheide, MD, FAHA; Brian Eigel, PhD; Robert W. Hickey, MD, FAHA; W.T. Longstreth, Jr, MD, FAHA; Vinay Nadkarni, MD, FAHA; Graham Nichol, MD, FAHA; Michael R. Sayre, MD; Claire E. Sommargren, RN, PhD, FAHA; Mary Fran Hazinski, RN, MSN, FAHA

Key Words: AHA Scientific Statement • cardiopulmonary resuscitation • resuscitation • heart arrest • defibrillation

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Sudden cardiac arrest (SCA) is a leading cause of death in the United States and Canada. In the United States, each year 330 000 people die of coronary heart disease out of the hospital or in emergency departments. Of these, >150 000 SCAs occur out of the hospital.^1,2 Despite the development of electrical defibrillation and the more recent implementation of lay rescuer defibrillation programs, the vast majority of these victims do not leave the hospital alive. In studies over the past 15 years, only 1.4% of patients with out-of-hospital arrest in Los Angeles, Calif, survived to hospital discharge³; in Chicago, Ill, the number was 2%,⁴ and in Detroit, Mich, it was <1%.⁵ Conversely, a few municipalities such as Seattle, Wash, report much higher survival rates from SCA—more than 15% in 1 study⁶—which suggests that survival rates need not remain so low. Recent work in Europe and elsewhere has confirmed that a higher survival-to-hospital discharge rate is indeed a realistic goal, with survival rates as high as 9% reported in Amsterdam⁷ and 21% in Maribor, Slovenia.⁸

The American Heart Association (AHA) uses 4 links in the "chain of survival" to illustrate the time-sensitive actions required for victims of SCA: (1) early recognition of the emergency and activation of emergency medical services (EMS), (2) early bystander cardiopulmonary resuscitation (CPR), (3) early delivery of shock(s) from a defibrillator if indicated, and (4) early advanced life support and postresuscitation care. Immediate bystander recognition of the emergency and EMS activation are critical. In . . . [Full Text of this Article]

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