Establishing Arizona's statewide cardiac arrest reporting and educational network.

BACKGROUND Only a few large cities have published their out-of-hospital cardiac arrest (OHCA) survival statistics using the Utstein style reporting method. To date, to the best of our knowledge there has been no published OHCA survival data for a state. OBJECTIVE To describe the process, benefits, and challenges of establishing a statewide OHCA database and educational network. METHODS Arizona's Bureau of Emergency Medical Services and Trauma System initiated a statewide, prospective, observational cohort review of all OHCA victims on whom resuscitation was attempted in the field. Emergency medical services (EMS) first care reports, voluntarily submitted by 35 departments in Arizona, were analyzed. We chronicled the development of our data-collection process along with how we obtained patient outcomes and delivered feedback to field providers. Entry data included time intervals and nodal events conforming to the Utstein style template. RESULTS In data collected between January 1, 2005, and April 1, 2006, there were 1,484 OHCAs reported, of which 1,104 were of presumed cardiac etiology occurring prior to EMS arrival. The OHCA incidence was approximately 0.44 per 1,000 population per year. In our database, bystander CPR provided an odds ratio of 3.0 for survival (95% confidence interval 1.3, 6.7). Outcomes for 1,076 patients were obtained. Thirty-seven (3.4%) of the 1,076 cardiac arrest victims survived to hospital discharge. Twenty-seven (8.6%) of the 331 ventricular fibrillation cardiac arrest victims survived to hospital discharge. CONCLUSION It is feasible for a public health agency to implement a voluntary, statewide data-collection system and educational network to determine and improve survival from OHCA.