Archived Publications High-Quality CPR: Breathing New Life into Your Tra | Page 9

Most hospitals in the U.S. use traditional classroom
instruction to train employees in CPR, with only
about 30% making the switch to the American
Heart Association’s HeartCode ® program that
includes online instruction coupled with practice
using Voice-Assisted Manikins. Those who have
made the upgrade have seen improvements in CPR
quality, code response rates, and employee
confidence and competence.
Cardiac Arrest is a Leading
Cause of Death
Internationally, more than 135 million cardiovascular
deaths occur each year, and this number is increasing.
Across the globe, for every 100,000 people, cardiac
arrests range from 20-140 people. Unfortunately,
survival rates are low and range from 2 – 11 %
(Meaney, et al., 2013).
In the U.S., survival rates are slightly higher but still
less than 15%. Cardiac arrest is a leading killer in the
U.S. “claiming more lives than colorectal cancer,
breast cancer, prostate cancer, influenza, pneumonia,
auto accidents, HIV, firearms, and house fires
combined” (Meaney et. al., p. 418).
Even in hospital settings, survival rates are surprisingly
low and typically range from 15 – 20%. Interestingly,
there is a difference in survival rate based on the time
of day that the arrest occurs. For example, there is a
20% survival rate if the arrest occurs between 7 AM
and 11 PM. However, the survival rate drops to 15% if
the arrest occurs between 11 PM and 7 AM. Meany
et al. also reported that there is a survival difference
based on the interaction between location in the
hospital and time of the arrest. There is only a 9%
survival rate if the arrest occurs in an unmonitored
setting at night. The rate increases to about 37% if the
arrest occurs during the day in the operating room or
a post-anesthesia unit. Clearly, there is an opportunity
in the U.S. healthcare system to reduce variation and
improve overall survival rates from cardiac arrest.
The panel recommended
continuous training
programs that are
characterized by
frequent and short
training sessions.
High-Quality CPR is a Helpful Defense
Prompt and effective CPR intervention has shown to
be helpful in improving survival from cardiac arrest.
The amount of time between the cardiac event and
the performance of high-quality CPR is related to
survival (Kardong-Edgren, Oermann, Odom-Maryon,
and Ha, 2010). The depth and rate of compressions
used during CPR has also been shown to impact the
outcome of cardiac arrest. “When rescuers compress
at a depth of < 38 mm, survival-to-discharge rates
after out-of-hospital arrest are reduced by 30%.
Similarly, when rescuers compress too slowly, return
of spontaneous circulation (ROSC) after in-hospital
cardiac arrest falls from 72% to 42%.” In the 2010
Consensus Statement of the American Hospital
Association, Dr. Peter A. Meaney, MD, MPH, of
Children’s Hospital of Philadelphia, and colleagues
conclude, “Poor-quality CPR should be considered a
preventable harm” (Meaney et al., p. 418).
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