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Nine out of 10 people who suffer from cardiac arrest outside a hospital die, but survival rates could be improved dramatically with more CPR training, a nationwide registry and other strategies, according to a report released Tuesday by the Institute of Medicine.

Cardiac arrest results from an electrical malfunction in the heart, which leads to an erratic heartbeat and loss of blood flow throughout the body. Cardiac arrests claim more than 500,000 lives a year in the U.S.

“The report provides a clear and comprehensive pathway to improving outcomes that could save thousands of lives annually,” said Robert W. Neumar, M.D., Ph.D., professor and chair of the department of emergency medicine at the University of Michigan Medical School in Ann Arbor, and the chair of the American Heart Association’s emergency cardiovascular care committee.

AHA CEO Nancy Brown said the strategies in the report support the association’s goal of doubling cardiac arrest survival, which will save an additional 50,000 cardiac arrest victims each year.

“We need novel and innovative approaches to improve survival at national, state and local levels,” Brown said in a statement. “That’s why we applaud the IOM for calling for a culture of action and for their unbiased and authoritative advice on critical health issues facing our country.”

The IOM report outlined eight strategies for improving survival nationwide:

  • Establishing a national cardiac arrest registry.
  • Increasing public awareness and CPR training.
  • Enhancing the capabilities and performance of emergency medical services systems.
  • Setting national cardiac arrest accreditation standards for hospitals and healthcare systems.
  • Adopting continuous quality improvement programs.
  • Accelerating research on pathophysiology, new therapies and the translation of cardiac arrest science.
  • Accelerating research on the evaluation and adoption of cardiac arrest therapies.
  • Creating a national cardiac arrest collaborative.

Of the recommendations, creating a national cardiac arrest registry is the most visible priority, said Clifton Callaway, M.D., Ph.D., associate professor at the University of Pittsburgh and the incoming chair of the AHA’s emergency cardiovascular care committee.

“If we can’t measure what’s happening, I don’t know how we can improve the response or delivery of care,” he said.

The IOM report recommends that the federal government bring together data from different states and research networks, which builds on the AHA’s previous efforts, Callaway said.

“We have made significant progress in a number of areas including CPR training in schools, AED deployment, dispatcher-assisted CPR, emphasis on high-quality CPR by EMS providers, and improved post-cardiac arrest care,” Neumar said. “However in all of these areas much more work is needed to achieve widespread implementation.”

The American Heart Association issued a special report in response to the IOM report, outlining its bolstered commitment to strengthen public awareness, improve data collection and drive funding for AHA programs that support cardiac arrest survival:

  • Providing up to $5 million over 5 years to encourage the collection and sharing of resuscitation data;
  • Securing support for improving local and regional systems of care;
  • Securing support for a resuscitation research network; and
  • Improving collaboration and survival by co-sponsoring a national cardiac arrest summit.

“Working together we can save thousands of lives every year in the United States,” Neumar said.

  •  More on the IOM report and AHA response