Response to The New York Times article: CPR Survival Rates Can Differ Greatly by City

In a recent article titled, “CPR Survival Rates Can Differ Greatly by City,” The New York Times wrote about the discrepancies in survival rates across the country and even in the hospital setting. We thank The New York Times for highlighting the importance of creating a culture of action to improve survival from cardiac arrest. As a leader in resuscitation science and innovation, we are committed to saving more lives through our CPR, first aid and advanced cardiovascular care training materials, as well as our programs and awareness campaigns.

The article focuses on the need for improvements both in communities and in hospitals. This is something we agree with, and it’s why we’re leading the way with our education, training and quality improvement initiatives, all backed by the latest resuscitation science.

While we’re glad this article shines a national spotlight on the importance of lifesaving CPR, we also worry it sends some mixed messages and missed an opportunity to discuss what is currently being done to improve survival rates and the overall quality of CPR.

Here’s a list of the article’s key points, as well as some ways we’re already working towards a solution.

Improving survival rates:

The piece references the survival rate for out-of-hospital cardiac arrest (OHCA) is about 10 percent, but depending on where you live, your chance of survival could be very different. For example, Seattle King County has worked for over seven years to strengthen their systems of care to increase bystander CPR rates and EMS systems, and as a result, they increased their survival rate to 19.9 percent. The article notes that cities like Detroit have a survival rate of about 3 percent.

The article also touches on mistakes healthcare providers make by checking for breaths too long or not performing CPR long enough.

What you should also know: it takes a village

• The latest AHA Guidelines Update calls for strengthened systems of care to increase survival. It must be a coordinated effort between communities, EMS systems and health systems.
• If every system of care focused on high-quality CPR and implemented AHA Guidelines, we would greatly improve survival rates system-wide. With King County as an example, we know it takes lots of hard work and dedication to ensure high quality implementation.
• For years we’ve focused on educating the public about cardiac arrest and CPR through public service announcements and CPR awareness campaigns for the general public. We’re building the next Generation of Lifesavers™ with our CPR in Schools effort and helping more people learn the easy steps to save a life with our Hands-Only CPR campaign.
• Timely CPR doubles or even triples the chance of survival from OHCA.  We also know that high-quality CPR by healthcare professionals improves outcomes.  We know that we can save more lives, which is why we created a goal in 2010 to double cardiac arrest survival by 2020. Saving lives is why we believe in training people in CPR (we currently train about 17 million people worldwide each year).

What about in-hospital care?

While there have been numerous advancements in care, in-hospital survival stands at about 20 percent. The article says the major cause of variations in outcomes is lack of systematic benchmarking of cardiac arrest data.

There are several references in the article that suggest poor CPR performance within hospitals, and how poor performance can harm the patient even if they received immediate bystander CPR before arriving to the facility.

What you should also know: more data and advanced technology are part of the solution

• Centralized and standardized data collection is key, and we’re working hard with other organizations to make that a reality. Check out our Special Report for more information about the commitments we’re making in this area.
• Education guidelines highlight that resuscitation skills can decline within a few months – far before the two-year current evaluation standard.
• The latest guidelines reinforce that more-frequent, High-Quality CPR training can help hospitals deliver the highest quality of emergency cardiovascular care to patients.
• We launched the Resuscitation Quality Improvement (RQI) program targeting EMS and hospital professionals to ensure their CPR competency is maintained with the intent of improving resuscitation quality and patient outcomes.
• Our quality improvement programs such as Get With the Guidelines-Resuscitation and Mission Lifeline: Resuscitation provide tools, data and feedback to healthcare professionals to ensure they could monitor and close any gaps in resuscitation quality performance.

I hope this information gives you a good look at the state of CPR training and quality. Want to learn more about how to save a life? Head over to cpr.heart.org and be sure to subscribe to my blog in the footer below to always be the first to know about our latest advancements in emergency cardiovascular care.