Johnson County is a participant in a nationwide cardiac arrest data collection program called CARES or Cardiac Arrest Registry to Enhance Survival. Participating agencies submit their local data about nontraumatic, cardiac arrest 911 calls where the heart was believed to be the cause of death and not other causes of death such as infection. An example of the data collected is if the person was seen to collapse or found dead? Did anyone perform CPR? Did anyone use an AED or defibrillator? JoCo's data is combined with other departments' data around the country to be used to help communities benchmark and improve their performance for OHCA or Out of Hospital Cardiac Arrest. Look at the map to see CARES participants in Kansas. It is important to know that there is no standardized data collecting tool in the nation, but CARES is a well-recognized data tool.
Overall survival rate
In 2021, CARES participants throughout the nation reported that 131,547 people experienced sudden cardiac arrest where 911 was called to help. 6,302 of those people were discharged alive from the hospital for an overall survival rate of 9%. In 2021, JoCo 911 responders cared for 446 people who experienced sudden cardiac arrest with 40 of those people discharged alive from the hospital for a survival rate of 15%. There are many factors that play into the overall survival rate. The most important factors are if the person was witnessed to collapse, was also recognized to need CPR, an AED was available, and the AED delivered a shock. The information below will address some of these factors.
Bystander CPR
If CPR is performed prior to 911 arrival, the patient's chance of survival dramatically increases. In 2021, JoCo bystanders performed CPR 70% of the time prior to the arrival of 911 responders. CARES participants reported a combined bystander CPR rate of 40%. An important factor in this difference is JoCo 911 call takers or dispatchers quickly determine over the phone if the patient is in need of CPR and provide instructions to the bystander on how to perform chest compressions while waiting for 911 responders.
Public AED use
Reducing delays in using an AED commonly called a defibrillator to shock the heart also dramatically increases the chance of the person surviving. In 2021, CARES participants reported an AED was used 9% of the time compared to JoCo 11%. Both of these numbers are low because most cardiac arrest events happen at home where an AED is less likely to be located.
Ultstein Bystander survival rate
The Ultstein bystander survival rate is calculated using 3 data fields that most dramatically impact the survival of a person in cardiac arrest. First, was the person witnessed to collapse? Next, did a bystander perform CPR and/or use an AED? Last, did the AED deliver a shock to the heart? In 2021, the nationwide Ulstein rate determined by CARES participants was 33%. This means that 33% of those 131,457 people that fit this formula survived to be discharged from the hospital. In 2021, JoCo's Ulstein survival rate was 46%. A person's best chance of surviving cardiac arrest is if they are seen to need CPR and an AED is available.
What does this all mean?
First, JoCo 911 system has to continue to participate in cardiac arrest data collection to measure data and evaluate areas needing improvement. Next, additional AED needs to be placed into the community where cardiac arrests are most likely to occur. Ideally, in every residence similar to a smoke detector. Last, as a population, we need to continually improve our understanding and awareness of cardiac arrest, and ultimately come to consider CPR/AED training as a normal part of life. Johnson County HeartSafe members strive to help.