Program to Integrate Technology and Cardiac Arrest Resuscitation

Focus: 

To improve cardiac resuscitation technology and resuscitation outcomes

Anticipated Impact: 

Statewide training and implementation of improved cardiac resuscitation methods and enhanced survival following sudden cardiac arrest

Abstract: 

Out-of-hospital heart attacks, or sudden cardiac arrests, are a major public health challenge and account for 10 percent of deaths in the United States. Cardiac arrest occurs when the heart is unable to circulate blood, usually because of a disorganized heart rhythm. Across the nation emergency medical services (EMS) attempt resuscitation in hundreds of thousands of victims each year with less than 20 percent being successful, indicating an opportunity to advance public health if resuscitation therapies and technology can be improved. Public health researchers from the Seattle & King County Department of Public Health will work to improve on technology applications that affect sudden cardiac arrest outcomes. They will couple clinical resources with corporate and EMS stakeholders whose experience spans the technical, research, and clinical components of resuscitation.

Each year 4,000 Washingtonians suffer a sudden cardiac arrest. Low survival rates indicate room for improvement. Successful resuscitation requires a coordinated, time-sensitive set of rescuer actions that integrate activation of emergency response, CPR, defibrillation, and advanced medical therapies, collectively called the 'links in the chain of survival.' Across these 'links,' there is a strong interface between technology and human. The technologies include defibrillator-monitors, devices that aid CPR, and communication tools. Researchers hope to better integrate these technologies to develop complementary resuscitation methods including active guidance of rescuer actions during resuscitation and innovative approaches for education. Findings and practices will be translated across the state using a web-based training tool and a  resuscitation training academy.

See also:

Cardiopulmonary Resuscitation

Grant Update

Principal Investigator:
Thomas Rea
Grantee Organization:
Seattle & King County Department of Public Health
Grant Title:
Program to Integrate Technology and Cardiac Arrest Resuscitation
Grant Cohort and Year:
2008 Innovative Programs to Advance Health Research (02)
Grant Period:
08/07/2009 - 08/06/2014 (Completed)
Grant Amount:
$2,637,389
Collaborating Organizations:
University of Washington, Philips Medical, Physio-Control, Inc.
The Program spans all the links in the “chain of survival” for cardiac arrest resuscitation and so encompasses several projects that incorporate strategies to investigate and disseminate improvements in resuscitation care. The Program investigators also continue to rigorously evaluate the physiology and care for cardiac arrest in an effort to identify treatment strategies that can be translated to community-based improvements in resuscitation. For example, the investigators evaluated the CPR duty cycle. The duty cycle measures the relative proportion of time spend in compression relative to the entire compression-decompression cycle. Although featured in national CPR guidelines, there is no systematic assessment from human resuscitation. The Program was able to adapt technology to rigorously evaluate the CPR duty cycle in human resuscitation. The provocative results indicate that a characteristic duty cycle spends only about a third of the cycle in compression compared to two-thirds in decompression. The results – observed in a system with superior survival – suggest that the 50-50 guideline may not be optimal and have important implications for training and mechanical CPR devices. The Program continues to work toward Statewide translation of best care practices for cardiac arrest resuscitation. The Program has gained momentum in Washington State as a consequence of the Resuscitation Academy. The Academy has gone from once per year to now a plan for a half dozen offerings in the current calendar year. The Academy leverages the Program’s core understanding and new developments in resuscitation. Program investigators have collaborated with Emergency Medical Services leaders from across the State to engage in a Resuscitation Academy (resuscitationacademy.org), which seeks to improve resuscitation in each community based on a community’s opportunities and strengths. These programmatic efforts have been complimented by key investigator roles in a number of scientific and programmatic publications that span the links in the chain of cardiac arrest resuscitation and survival. We have leveraged Program resources and initiative to garner additional support aimed at Statewide dissemination and scientific advancement. We have implemented a Washington State registry for cardiac arrest and engaging Washington State stakeholders to participate and improve care through rigorous and systematic measurement. The registry results demonstrate a strong collective statewide effort aimed at resuscitation. We are pleased that currently nearly 90% of Washington State population is participating in the Cardiac Arrest Registry to Enhance Survival (CARES). As one of 9 states participating in CARES nationally, Washington State has achieved the highest statewide overall cardiac arrest survival (15.4%) and highest witnessed ventricular fibrillation survival (45.5%). Importantly overall Statewide survival has improved substantially from 11.5% in 2011 to 15.4% in 2013 – an improvement that translates to an additional 130 cardiac arrest survivors in Washington State in 2013. As a consequence of progress, the Program has attracted follow-on funding and Program investigators continue to leverage new discovery to apply for research support. For example, intellectual property developed as part of the Program was the basis for a license agreement with Philips Inc that will commercialize promising technology to improve resuscitation care. Moreover, this new relationship will support ongoing innovation in defibrillator technology as Program investigators and industry scientists continue to collaborate to move technology forward through the different phases of commercial implementation and regulatory approval. In summary, the work of the Program has benefitted scientific knowledge and community care in an effort to improve cardiac arrest outcomes, and reduce the burden of one of the most common killers in Washington and the United States. This programmatic and scientific progress has enabled formal and supported collaboration with industry stakeholders in an effort to advance resuscitation care.

Impact in Washington

Location of LSDF Grantee
Locations of Collaborations/Areas of Impact
Seattle
Federal Way
Bothell
Redmond
Bellevue
Bremerton
Friday Harbor
Yakima
Aberdeen
Anacortes
Bellingham
Bonney Lake
Chehalis
Chelan
Cle Elum
Coupeville
Eastsound
Everett
Kingston
Olympia
Port Townsend
Spokane
Vancouver
Wenatchee
White Salmon
Bainbridge Island
Port Angeles
Shelton
Kelso
Stevenson
Waterville
Okanogan
Moses Lake
Richland
Pasco
Walla Walla
Dayton
Asotin
Colfax

Legislative Districts:
, 1, 3, 4, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 19, 20, 22, 23, 24, 26, 30, 31, 34, 35, 36, 37, 38, 40, 41, 42, 43, 46, 48, 49

Health Impacts

Cardiopulmonary Resuscitation