The formula for survival in resuscitation

Eldar Søreide; Laurie Morrison; Ken Hillman; Koen Monsieurs; Kjetil Sunde; David Zideman; Mickey Eisenberg; Fritz Sterz; Vinay M. Nadkarni; Jasmeet Soar; Jerry P. Nolan

doi:10.1016/j.resuscitation.2013.07.020

The formula for survival in resuscitation

Eldar Søreide^*, Laurie Morrison, Ken Hillman, Koen Monsieurs, Kjetil Sunde, David Zideman, Mickey Eisenberg, Fritz Sterz, Vinay M. Nadkarni, Jasmeet Soar, Jerry P. Nolan

^*Corresponding author for this work

Research output: Contribution to journal › Article (Academic Journal) › peer-review

165 Citations (Scopus)

Abstract

The International Liaison Committee on Resuscitation (ILCOR) Advisory Statement on Education and Resuscitation in 2003 included a hypothetical formula - 'the formula for survival' (FfS) - whereby three interactive factors, guideline quality (science), efficient education of patient caregivers (education) and a well-functioning chain of survival at a local level (local implementation), form multiplicands in determining survival from resuscitation. In May 2006, a symposium was held to discuss the validity of the formula for survival hypothesis and to investigate the influence of each of the multiplicands on survival. This commentary combines the output from this symposium with an updated illustration of the three multiplicands in the FfS using rapid response systems (RRS) for medical science, therapeutic hypothermia (TH) for local implementation, and bystander cardiopulmonary resuscitation (CPR) for educational efficiency. International differences between hospital systems made it difficult to assign a precise value for the multiplicand medical science using RRS as an example. Using bystander CPR as an example for the multiplicand educational efficiency, it was also difficult to provide a precise value, mainly because of differences between compression-only and standard CPR. The local implementation multiplicand (exemplified by therapeutic hypothermia) is probably the easiest to improve, and is likely to have the most immediate improvement in observed survival outcome in most systems of care. Despite the noted weaknesses, we believe that the FfS will be useful as a mental framework when trying to improve resuscitation outcome in communities worldwide.

Original language	English
Pages (from-to)	1487-1493
Number of pages	7
Journal	Resuscitation
Volume	84
Issue number	11
DOIs	https://doi.org/10.1016/j.resuscitation.2013.07.020
Publication status	Published - Nov 2013

Bibliographical note

Funding Information:
ES has received unrestricted research grant funding from the Laerdal Foundation for Acute Medicine. LJM receives salary support from the National Institute of Health to conduct clinical trials in out-of-hospital cardiac arrest. Dr Morrison has operating grants from the Canadian government (Canadian Institute of Health Research) and charitable foundations (American Heart Association, Heart and Stroke Foundation of Canada and the Laerdal Foundation) to conduct implementation research in both in-hospital and out-of-hospital cardiac arrest. KH has share option with Sotera, a monitoring device company. KM has received unrestricted research grant funding from the Laerdal Foundation for Acute Medicine and from Zoll Medical. KS, FS, ME have no conflict of interest. DZ has received unrestricted research grant funding from the Laerdal Foundation for Acute Medicine. VN: has received unrestricted research grant funding from the Laerdal Foundation for Acute Medicine, Laerdal Medical Corp., National Institutes of Health, and Agency for Healthcare Research and Quality. JS is an editor of Resuscitation. JN is Editor-in-Chief of Resuscitation.

Funding Information:
The 2006 Utstein meeting on FfS was generously supported by an unrestricted grant from the Laerdal Foundation for Acute Medicine , Stavanger, Norway

Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.

Keywords

Cardiac arrest
Formula for survival
Implementation
Outcome

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title = "The formula for survival in resuscitation",

abstract = "The International Liaison Committee on Resuscitation (ILCOR) Advisory Statement on Education and Resuscitation in 2003 included a hypothetical formula - 'the formula for survival' (FfS) - whereby three interactive factors, guideline quality (science), efficient education of patient caregivers (education) and a well-functioning chain of survival at a local level (local implementation), form multiplicands in determining survival from resuscitation. In May 2006, a symposium was held to discuss the validity of the formula for survival hypothesis and to investigate the influence of each of the multiplicands on survival. This commentary combines the output from this symposium with an updated illustration of the three multiplicands in the FfS using rapid response systems (RRS) for medical science, therapeutic hypothermia (TH) for local implementation, and bystander cardiopulmonary resuscitation (CPR) for educational efficiency. International differences between hospital systems made it difficult to assign a precise value for the multiplicand medical science using RRS as an example. Using bystander CPR as an example for the multiplicand educational efficiency, it was also difficult to provide a precise value, mainly because of differences between compression-only and standard CPR. The local implementation multiplicand (exemplified by therapeutic hypothermia) is probably the easiest to improve, and is likely to have the most immediate improvement in observed survival outcome in most systems of care. Despite the noted weaknesses, we believe that the FfS will be useful as a mental framework when trying to improve resuscitation outcome in communities worldwide.",

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author = "Eldar S{\o}reide and Laurie Morrison and Ken Hillman and Koen Monsieurs and Kjetil Sunde and David Zideman and Mickey Eisenberg and Fritz Sterz and Nadkarni, {Vinay M.} and Jasmeet Soar and Nolan, {Jerry P.}",

note = "Funding Information: ES has received unrestricted research grant funding from the Laerdal Foundation for Acute Medicine. LJM receives salary support from the National Institute of Health to conduct clinical trials in out-of-hospital cardiac arrest. Dr Morrison has operating grants from the Canadian government (Canadian Institute of Health Research) and charitable foundations (American Heart Association, Heart and Stroke Foundation of Canada and the Laerdal Foundation) to conduct implementation research in both in-hospital and out-of-hospital cardiac arrest. KH has share option with Sotera, a monitoring device company. KM has received unrestricted research grant funding from the Laerdal Foundation for Acute Medicine and from Zoll Medical. KS, FS, ME have no conflict of interest. DZ has received unrestricted research grant funding from the Laerdal Foundation for Acute Medicine. VN: has received unrestricted research grant funding from the Laerdal Foundation for Acute Medicine, Laerdal Medical Corp., National Institutes of Health, and Agency for Healthcare Research and Quality. JS is an editor of Resuscitation. JN is Editor-in-Chief of Resuscitation. Funding Information: The 2006 Utstein meeting on FfS was generously supported by an unrestricted grant from the Laerdal Foundation for Acute Medicine , Stavanger, Norway Copyright: Copyright 2013 Elsevier B.V., All rights reserved.",

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doi = "10.1016/j.resuscitation.2013.07.020",

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AU - Hillman, Ken

AU - Monsieurs, Koen

AU - Sunde, Kjetil

AU - Zideman, David

AU - Eisenberg, Mickey

AU - Sterz, Fritz

AU - Nadkarni, Vinay M.

AU - Soar, Jasmeet

AU - Nolan, Jerry P.

N1 - Funding Information: ES has received unrestricted research grant funding from the Laerdal Foundation for Acute Medicine. LJM receives salary support from the National Institute of Health to conduct clinical trials in out-of-hospital cardiac arrest. Dr Morrison has operating grants from the Canadian government (Canadian Institute of Health Research) and charitable foundations (American Heart Association, Heart and Stroke Foundation of Canada and the Laerdal Foundation) to conduct implementation research in both in-hospital and out-of-hospital cardiac arrest. KH has share option with Sotera, a monitoring device company. KM has received unrestricted research grant funding from the Laerdal Foundation for Acute Medicine and from Zoll Medical. KS, FS, ME have no conflict of interest. DZ has received unrestricted research grant funding from the Laerdal Foundation for Acute Medicine. VN: has received unrestricted research grant funding from the Laerdal Foundation for Acute Medicine, Laerdal Medical Corp., National Institutes of Health, and Agency for Healthcare Research and Quality. JS is an editor of Resuscitation. JN is Editor-in-Chief of Resuscitation. Funding Information: The 2006 Utstein meeting on FfS was generously supported by an unrestricted grant from the Laerdal Foundation for Acute Medicine , Stavanger, Norway Copyright: Copyright 2013 Elsevier B.V., All rights reserved.

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The formula for survival in resuscitation

Abstract

Bibliographical note

Keywords

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