Author Affiliations: Dr Olson is a Contributing Editor and Dr Fontanarosa is interim Coeditor of JAMA.
At least 250,000 people experience sudden cardiac death outside of
hospitals each year in the United States.1 Despite
application of techniques ranging from basic cardiopulmonary
resuscitation (CPR), through "first responder" defibrillation using
automatic external defibrillators, to advanced cardiac life support
(including airways and drugs) by emergency medical service (EMS)
personnel, survival rates for out-of-hospital cardiac arrest are as low
as 1.4%,2 although rates vary widely.3 Even
more troublesome than the low survival rates is the difficulty in
maximizing the functional ability of those who survive. Clearly, any
process that is as widely applicable but has such poor success as
resuscitation needs continuous reevaluation and evidence-based
strategies for improvement.
Olson CM, Fontanarosa PB. Advancing Cardiac ResuscitationLessons From Externally Controlled Trials. JAMA. 1999;281(13):1220-1222. doi:10.1001/jama.281.13.1220