Regional Centers for Cardiac Arrest: Will Anyone Listen?

Today, an expert panel put together by the American Heart Association released detailed recommendations for establishment of a network of regional centers to provide acute care to patients who experience out-of-hospital cardiac arrest (OOHCA). 

courtesy Flickr user sztyui

The report documents what a killer OOHCA can be, slaying 300,000 Americans annually, but it also notes a striking, fivefold disparity in mortality rates that now exists across the country. The reason: a few select locations have integrated, regional care systems in place that get patients to expert centers quickly so that state-of-the art treatment is applied. But right now, most of the U.S. lacks these centers and a system to bring patients to them. 

My news story on the report is here, and the expert policy statement is here

The report makes clear that the answer is to open specialized, regional centers around the country, tied to emergency medical services to bring patients in. These networks are modeled on the existing trauma centers and stroke centers that are in place throughout the U.S. 

It’s a wonderful concept. But the troubling question I had as I read the report was: Which people or groups would take this on as their mission, to ensure these regional centers come into being soon? 

The expert panel’s chair, Dr. Graham Nichol of the University of Washington in Seattle, told me that people committed to this cause, be they physicians, administrators, nurses, medics, or  others, will need to self-select themselves to take on this effort in each region or community. He added that the effort will have the support of the three groups that sponsored the report, the American Heart Association, the American College of Emergency Physicians, and the National Association of State EMS Officials, but mostly, Dr. Nichol said, the onus will be on individuals to act as local champions for this cause. 

I hope it works, but it sounds to me like a tall order and a leap of faith to think that organized OOHCA care centers will sprout up in the next few years like so many flowers blooming. 

But one fact in the report gives me reason to think that Dr. Nichol’s scheme will work. The report noted that as of April 2009, more than 500 certified stroke centers were in operation around the U.S. I wrote about stroke centers in their early days, about 5 years ago, and at that time, the end of 2004, about 60 stroke centers existed, and they came into being just about the same way that Dr. Nichol and his panel envisions for cardiac arrest centers.  Here’s hoping this history repeats itself. 

—Mitchel Zoler (on Twitter @mitchelzoler)

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Filed under Cardiovascular Medicine, Emergency Medicine, Health Policy, Hospital and Critical Care Medicine, IMNG, Internal Medicine, Practice Trends

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