Cardiac Arrest Survival

Stopping heart attacks from proving fatal and improving aftercare

There are 275,000 out of hospital cardiac arrests annually in Europe and it is the third leading cause of death, with a survival rate of only 12%. Warwick Medical School research, led by Professor Gavin Perkins and Dr Joyce Yeung, contributed to an improvement in patient care for cardiac arrest, cardiopulmonary resuscitation (CPR) and long term health outcomes by working with international and national standards bodies, charities, patients, doctors and the public.

The challenge

There is variation in survival outcomes from cardiac arrest and a lack of data and understanding of patient outcomes following an out of hospital cardiac arrest. Evidence demonstrated that bystanders rarely know how to respond, therefore patients often do not receive CPR; with fewer than one in forty receiving public access defibrillation. There has also been little research evidence to support treatments such as mechanical CPR and the use of adrenaline.

Our approach

Led by Professor Gavin Perkins, the Emergency Prehospital Perioperative & Critical Care Group have investigated standards of care and CPR decisions with a wide range of national and international collaborators, including:

• Ambulance services

• More than 100 NHS Trusts

• Charities such as the British Heart Foundation and St Johns Ambulance

• International and national standards bodies such as the International Liaison Committee on Resuscitation and the Resuscitation Council (UK)

The award winning PARAMEDIC1 clinical trial compared the effectiveness of mechanical and manual chest compression when performing CPR. PARAMEDIC2, a placebo-controlled trial, investigated the safety and effectiveness of adrenaline in out-of-hospital cardiac arrest patients. With the British Heart Foundation and the Resuscitation Council (UK), Warwick established the Out of Hospital Cardiac Arrest Outcome registry to improve data on patient outcome and led the development of a core outcome set for reporting on effectiveness studies of cardiac arrest.

Our impact

The findings have influenced policy and guidance on cardiac arrest care around the world. PARAMEDIC1 demonstrated that mechanical chest compression was no more effective than manual methods of CPR: As a result, the NHS saved £40 million by not investing in this specialist equipment. Evidence of poor community CPR response has led to the inclusion of CPR on the National Curriculum; and over 1 million young people being taught lifesaving skills. This raised the bystander response rate from 57% to 69% over the last five years, saving an additional 1000 lives.

Following evidence of low rates of public access defibrillator use and potential number of lives that could be saved with increased uptake, the group secured a £3 million investment to work with the Department of Health and the British Health Foundation to map and install a national network of defibrillators; open to emergency use by the public and marked by clear signage.

Find out more about the PARAMEDIC 2 adrenaline trial