Sudden cardiac arrest and resuscitation - An analysis of the years 2007 and 2008 in Germany

Out-of-hospital and in-hospital management of cardiac arrest represents a unique challenge to the emergency medical and rescue services and the hospital team. The success of their efforts is determined largely by the unalterable circumstances of the cardiac arrest. Recent studies, however, show that outcome is additionally and significantly influenced by the quality of the medical measures applied. The German Resuscitation Register of the Deutschen Gesellschaft fur Anasthesiologie und Intensivmedizin (DGAI) (German Society for Anaesthesiology and Intensive Care Medicine) contains data recorded since the initiation of in-hospital and out-of-hospital resuscitation in 2007. Currently, a total of 7,712 data sets entered by 47 participating emergency medical and rescue services are available for a detailed analysis of the care initially provided, as also for a comparison of centers - already implemented online within the data bank structure. In the majority of cases, out-of-hospital collapse and resuscitation took place in a domestic setting and were due to a cardiac problem. Despite a witness rate in excess of 50 %, fewer than 20 % of the necessary reanimation measures were initiated by lay persons. The data of the emergency medical and rescue services contained in the German Resuscitation Register reveal a rate of successful resuscitation higher than in the USA and comparable with the Copenhagen rate of 42 % ROSC (return of spontaneous circulation) and 36 % hospital admission. In subgroups (observed circulatory arrest, cardiac cause, ventricular fibrillation). Some centers even achieved a primary success rate of more than 80 %. In addition to the implemented standard evaluations, the Resuscitation Register offers options for detailed analyses aimed at improving the quality of on-the-spot care, and possibility of providing support for training concepts and research projects.