Resuscitation in Europe: a tale of five European regions
Introduction
Over the past decades there has been a heightened awareness of the importance of sudden cardiac death and appreciation of the therapeutic implications. This has been one reason for the development of out-of-hospital emergency medical service(s) (EMS) [1].
Although originally introduced by Pantridge in Northern Ireland [2] this development took place most rapidly in Seattle, King County, USA [3]. During the last two decades various regions in Europe have reported success in terms of improved survival after an out-of-hospital cardiac arrest [4], [5], [6]. The present survey describes resuscitation in five centres in Europe and was initiated by an invitation lecture by the organizing committee of the 4th Congress of the European Resuscitation Council (ERC) with the title ‘Resuscitation in Europe at its best: A tale of five European regions’.
Section snippets
Methods
Based on recommendations from the secretary of the organizing committee of the 4th Congress of the European Resuscitation Council persons in the following countries were approached: Norway, Sweden, Denmark, Finland, Iceland, Scotland, England, Germany, The Netherlands, Belgium, France, Switzerland, Italy, Spain, Austria and Slovenia regarding their EMS systems.
Based on their response, key persons in the following EMS systems were contacted: Stavanger, Oslo, Trondheim and Fredrikstad (Norway);
Initial survey
The overall survival rate varied from 23% in Stavanger to 6% in Ljubljana. The corresponding figures for patients having suffered a bystander witnessed cardiac arrest of a cardiac aetiology varied from 35 to 6%. Seven EMS systems reported a survival rate of more than 20% for this group (Stavanger (35%), Göttingen (33%), Mainz (31%), Varkaus (28%), Reykjavik (23%), Helsinki (23%) and Bonn (21%) (Table 1).
Among patients having suffered a bystander witnessed cardiac arrest of a cardiac aetiology
Discussion
The aim of this study was to describe resuscitation in five different regions in Europe.
It must be emphasized that some of the information is based on a small sample size and consequently the data have to be interpreted with caution. The data from Stavanger are not population based, but merely unit based.
It is possible that there are other regions in Europe in which EMS systems operate with similar results in terms of survival from an out-of-hospital cardiac arrest. Furthermore, EMS systems
Limitation
The aim of this manuscript is to give examples of resuscitation in Europe. The results in Table 1 should be used as background information and not as a comparison of the effectiveness between various organisations. Such a comparison could only be made if data were collected uniformly in a common data base. In this survey data were gathered during different time periods.
Factors other than medical performance or organisation may explain the differences between rescue organisations in terms of
Conclusion
This survey demonstrated the type of results that can be achieved for resuscitation after out-of-hospital cardiac arrest in Europe. There are links in the chain of survival which can be further improved even in the best of EMS systems. Future research will clarify whether some of the data, which were based on a relatively small sample size can be confirmed in a larger patient population. Whether survival after an out-of-hospital cardiac arrest can be further improved remains to be determined.
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