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    Faster Response Linked to Improved Cardiac Survival

    Changes in emergency medical services associated with better cardiac arrest outcomes

    WEDNESDAY, Jan. 28 (HealthDay News) -- During a recent period, improvements in the "chain of survival" were linked to increased survival following out-of-hospital cardiac arrests in a region of Japan, according to research published online Jan. 26 in Circulation: Journal of the American Heart Association.

    Taku Iwami, M.D., Ph.D., of the Kyoto University Health Service in Kyoto, Japan, and colleagues analyzed data from 8,782 arrests of presumed cardiac origin that were witnessed by bystanders between 1998 and 2006 in the Osaka Prefecture. During this period, emergency medical service personnel became authorized to administer shocks without online physician direction, and certain personnel became able to intubate and provide epinephrine. Also, cardiopulmonary resuscitation (CPR) training to the public is widespread.

    The investigators found that, during the study period, the median time from collapse to a call for medical help fell from four minutes to two minutes, the time to first CPR fell from nine to seven minutes, and the time to first shock fell from 19 to nine minutes. Among witnessed cardiac arrests outside of the hospital, earlier CPR and earlier intubation (odds ratios per minute 0.89 and 0.96, respectively) were linked to better neurological outcome, the report indicates.

    "The increased survival in Osaka over time is due mainly to improvements in the first three links in the chain of survival. Although the present study suggests the benefit of early-initiated advanced cardiac care, we need to recognize that our data confirm the greater importance of early CPR and early shock for increasing survival after out-of-hospital cardiac arrest," the authors write.

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