Cardiac arrest: survivors or still victims?

Worldwide, out-of-hospital cardiac arrest remains a lifelosing proposition for the vast majority of its victims. In the United States, prehospital emergency medical services (EMS) personnel attend an estimated 273 000 persons with out-of-hospital cardiac arrest (defined as circulatory or pulseless collapse) each year.1 Survival to hospital discharge from all presenting rhythms of cardiac arrest remains strikingly poor (median survival 6.4%) but varies widely across communities.2 The reasons for this wide variation in outcome are likely due in part to community differences in patient characteristics, bystander involvement, and EMS structure and care. This variation is also confounded by the nonuniform manner in which cardiac arrest itself is ascertained and reported.1