Regionalization of Sudden Cardiac Arrest Management
1Emergency Medicine, Yale Univeristy, United States of America
While the physiologic concept of post-resuscitation disease dates back to 1972, the concept of “cardiac arrest centers” or “resuscitation centers” was only proposed in the mid-2000s, as a way to leverage the benefits of institutional and provider volume and expertise for patients resuscitated from sudden cardiac arrest in the field, much as has been done for several decades with victims of major trauma (at designated trauma centers), burns (at designated burn centers), etc. Since that time, a number of studies have examined the benefits of the individual components (primarily interventions) of such a system, including targeted temperature management, universal cardiac angiography for all SCA survivors, mechanical cardiac support, and even consideration of organ donation. Smaller numbers of studies have examined EMS implications, including transport times and interfacility transfers. A number of authors have proposed criteria for designation of cardiac arrest or resuscitation centers, but to date no widespread organized systems exist for developing or credentialing such centers. This session will examine the data on survivor management at specialty centers, and the progress to date on organizing and structuring the cardiac arrest center concept.