Resuscitation Science in Circulation
A Timely Topic
Sudden cardiac arrest (SCA) is the most frequent cause of death in the United States and Europe. This devastating event touches almost everyone professionally and personally because most people have known family members, friends, and colleagues who died suddenly. The prevention and reduction of SCA remain important public health priorities. However, even with state-of-the art primary and secondary prevention, SCA continues to occur. Thus, resuscitation, and science to perfect it, will always be critical.
The American Heart Association has set an aggressive goal of reducing death from heart disease and stroke by 2020, including doubling the survival of those suffering SCA.1 Other resuscitation councils across the globe share this vision of improving outcomes for SCA victims.2,3 Attainment of this ambitious goal will require improvement in recognition of SCA coupled with adequate training of and prompt action by lay rescuers, dispatchers, emergency medical services, and hospital caretakers. Given the priority of SCA and the multiple knowledge gaps that remain, a themed Circulation issue addressing various aspects of resuscitation is timely.
Included in this issue are 7 original research articles, 3 research letters, 1 editorial, and 4 Frame of Reference articles, a new article type for Circulation. The research articles span the entire spectrum of resuscitation science, from prearrest identification to postarrest care. These original research manuscripts were not submitted in response to a call for papers for a themed issue but rather reflect those submitted routinely to the journal. The quality and scope of these submissions highlight the upward trajectory of research into SCA.
Topics addressed in these articles include prearrest risk stratification for SCA, analysis of pediatric and adult cardiopulmonary respiration (CPR), including chest compression-only CPR, timing of bystander CPR and emergency medical services arrival, epinephrine administration and hospital outcomes in in-hospital cardiac arrests, and treatment after resuscitation. Research letters evaluate the role of antiplatelet administration after percutaneous coronary intervention in SCA, incidence of pulmonary embolism in SCA, and the real-world experience of mechanical CPR. The 4 Frame of Reference articles offer more personal insight into resuscitation science.
Improving outcomes in SCA will require not only the endorsement and support of professional communities and engagement of healthcare professionals but also that of the public. Improving recognition of SCA and provision of timely CPR by everyone in the community are important steps toward this goal. Dispatch-directed CPR is penetrating communities and should play an increasing role. Shortening emergency medical services response time, directed resuscitation care, and care after resuscitation all play key roles in the improvement of outcomes for those suffering SCA.
Further improvement in resuscitation outcomes will require increased commitment to research led by the resuscitation community with the support of funding sources. Progress will require more complete and extensive data, prehospital randomized trials, additional data on when and in whom to perform cardiac interventions, and improved care after resuscitation. We at Circulation are excited about this issue of our journal, as we share the worldwide resuscitation community’s vision of markedly improving resuscitation outcomes.
The podcast and transcript are available as an online-only Data Supplement at http://circ.ahajournals.org/lookup/suppl/doi:10.1161/CIRCULATIONAHA.116.026473/-/DC1.
Circulation is available at http://circ.ahajournals.org.
- © 2016 American Heart Association, Inc.
- 1.↵American Heart Association. ECC: 2020 Impact Goals. http://cpr.heart.org/idc/groups/ahaecc-public/@wcm/@ecc/documents/downloadable/ucm_476079.pdf. Accessed December 7, 2016.
- 2.↵ECC: 2020 Impact Goals. http://cpr.heart.org/idc/groups/ahaecc-public/@wcm/@ecc/documents/downloadable/ucm_476079.pdf. Accessed November 18, 2016.
- 3.↵Cardiac Arrest: The European Parliament Mobilized. http://www.associationrmcbfm.fr/cardiac-arrest-the-european-parliament-mobilized/?lang=en. Accessed November 18, 2016.