Intended for healthcare professionals

Rapid response to:

Head To Head

Should we take patients to hospital in cardiac arrest?

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g5659 (Published 23 September 2014) Cite this as: BMJ 2014;349:g5659

Rapid Response:

The fact that we have, in the USA, a wide variability in SCA survival tells us that "better is possible." Phoenix recently improved from 26% to 56%. Kings County, Washington (Seattle) has enjoyed 50% + /- for twenty years. Hilton Head, SC has jumped from 10% to 66% in two years.

Yes, the resuscitation has to be achieved in the field, but there are subsequent actions that require hospital participation. For example (a) therapeutic hypothermia,and (b) hearth cath for SCAs caused by coronary artery blockage - frequently the LDA.

The change that needs to be made is not one of treating and calling in the field, but one of treating differently in the field and then either calling or transporting. There is so much more that we can do that is not being done.

Competing interests: No competing interests

25 September 2014
Robert H Trenkamp
Paramedic
17 Hasleiters Retreat, Savannah GA, USA