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April 7, 1999

Advancing Cardiac ResuscitationLessons From Externally Controlled Trials

Author Affiliations

Author Affiliations: Dr Olson is a Contributing Editor and Dr Fontanarosa is interim Coeditor of JAMA.

JAMA. 1999;281(13):1220-1222. doi:10.1001/jama.281.13.1220

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.

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