10 Steps

Benchmarking Communities Who Are Improving Cardiac Arrest Survival

A public health crisis

Out-of-hospital cardiac arrest is a sudden and dramatic medical emergency. 950 people are effected each day.

Without warning, the victim’s heart stops pumping and there is a loss of consciousness. A stopwatch starts at the moment of collapse. Within just 10 minutes, the probability for survival is greatly decreased if resuscitation efforts are not initiated.

Speed and quality are the low-hanging fruit for improving survival

Many communities around the nation and world have demonstrated a successful approach to continuously improving survival from cardiac arrest. Their plan consists of 10 specific steps as outlined by the Resuscitation Academy’s book 10 Steps for Improving Survival from Cardiac Arrest.

Steps 1 – 4 are considered foundational because of their ability to measure system effectiveness and improve the quality of the first 10 minutes (600 seconds) of a cardiac arrest incident.

10 Steps for Improving Survival from Cardiac Arrest

Exemplar Communities

When implemented and adapted locally, the 10-Steps optimize a community’s Chain of Survival. When each link in the Chain is strengthen, conditions for improved survival are improved. According to the academic template used to measure cardiac arrest survival (Utstein template), the number of these patients who survive to hospital discharge determines a community’s cardiac arrest save rate.

Compared to other communities, cardiac arrest victims are 2 to 3 times more likely to survive in Seattle & King County. Their current 5-year cumulative Utstein survival rate is 54%.

Hilton Head Island Fire Rescue responds to about 50 "workable" cardiac arrests a year. In 2017 Hilton Head Island Fire Rescue responded to 16 witnessed/shockable cardiac arrests and 11 survived to hospital. That put their survival rate at 68.75% for the year — one of the highest in the nation.

Detroit posted a dramatic increase in OHCA survival in Detroit between 2014 and 2016. (5% to 17.9%). Through strong leadership, comprehensive data collection, analysis and system improvements, they continue to improve their results year over year.

Denmark has become a prime example of implementing best resuscitation practice in Europe. They have achieved a remarkable tripling of survival from prehospital cardiac arrest over the past ten years. The current Utstein survival is 46%. Much of their success is due to increasing bystander CPR from 19% to 77%.

Out-of-hospital cardiac arrest is the most time-sensitive emergency we have: 600 seconds to act to save a life. Maryland’s Charles County is first in United States to pilot and adopt resuscitation quality improvement programs to advance prehospital response to cardiac arrest. Their median response time for a cardiac arrest call is 5:24, and the incidence of bystander CPR before arrival is 27.4%. Their overall cardiac arrest survival rate is 8.6%,while the Utstein survival rate is 36.4%.

Learn more about how to increase survival from cardiac arrest in your community.