From the Guidelines
The chance of survival decreases by 7% to 10% per minute without Cardiopulmonary Resuscitation (CPR) after cardiac arrest.
Key Factors Influencing Survival
- The time from collapse to defibrillation is critical, with survival rates decreasing significantly with each passing minute 1.
- The presence and quality of bystander CPR can significantly impact survival rates, with CPR decreasing the rate of decline in survival to 3% to 4% per minute 1.
Importance of Prompt Intervention
- Early defibrillation and CPR are essential for improving survival rates from sudden cardiac arrest 1.
- The use of automated external defibrillators (AEDs) can significantly improve survival rates when used promptly and correctly 1.
Clinical Implications
- Prompt recognition of cardiac arrest and immediate initiation of CPR and defibrillation (if available) are crucial for maximizing survival rates 1.
- Healthcare providers should emphasize the importance of bystander CPR and prompt defibrillation in cardiac arrest management 1.
From the Research
Rate of Decrease in Chance of Survival per Minute without Cardiopulmonary Resuscitation (CPR)
- The rate of decrease in chance of survival per minute without CPR is a critical factor in determining the outcome of cardiac arrest patients.
- According to 2, delays in initiation of CPR were associated with significantly decreased survival, with times to initiation of CPR greater than 2 minutes resulting in a survival rate of 14.7% compared to 17.1% if CPR was begun in 2 minutes or less.
- A study by 3 found a graded inverse relationship between time to bystander CPR and survival to hospital discharge, with patients who received CPR within 1 minute having a higher survival rate compared to those with a time to CPR of 2 to 3 minutes or longer.
- Another study by 4 reported a linear decrease in survival rate with age, with a loss of 3% survival chances every 5 years, which may be related to a shorter duration and less advanced life support.
- Research by 5 found that increasing time-to-ROSC was negatively associated with survival, with the yield of survivors per minute of resuscitation increasing from commencement and starting to decline in the 8th minute.
Key Findings
- Delays in CPR initiation are associated with decreased survival rates 2, 3.
- The rate of decrease in survival chances per minute without CPR is not explicitly stated in the studies, but it can be inferred that every minute counts, with survival rates decreasing significantly with longer delays in CPR initiation.
- The optimal time to consider transport to hospital for ECPR candidates is between 8 to 24 minutes of professional on-scene resuscitation, with 16 minutes balancing the risks and benefits of early and later transport 5.