Canada's Emergency Doctors Push to Improve Rate of "Bystander" CPR Assistance

OTTAWA, October 13, 2011 /Canada NewsWire/ - Canadians who suffer cardiac arrest outside of a hospital are three to four times more likely to survive if they receive cardiopulmonary resuscitation (CPR). According to the Canadian Association of Emergency Physicians (CAEP), such assistance is provided in only about one-quarter of cases.

In a position statement on "bystander" CPR to be published today in the Canadian Journal of Emergency Medicine (CJEM), CAEP says it is not acceptable that vast numbers of witnessed cardiac arrest victims do not receive bystander CPR. More than 20,000 people suffer out-of-hospital cardiac arrests in Canada each year, with 85 per cent of cases occurring in residential dwellings. Currently, less than 10 per cent of these people survive.

Every Canadian should be trained in CPR and all Canadians should respond and provide chest compressions, with or without mouth-to-mouth ventilation, whether they are trained or not, CAEP says.

Dr. Christian Vaillancourt, one of the lead authors of the position statement and a Senior Scientist at the Ottawa Hospital Research Institute, says "emergency department doctors too often see the missed opportunities to save someone's life had CPR been administered promptly. Many more lives can be saved, but we need stronger inducements and a systematic approach to ensure more people in the community are prepared and ready to perform CPR." Dr. Vaillancourt is an Emergency Physician at The Ottawa Hospital and Associate Professor of Emergency Medicine at the University of Ottawa.

The position statement's recommendations include:

...compulsory CPR education in high schools

...targeting senior citizens since they represent the population most at risk to witness a cardiac arrest

...tax exemptions for companies providing certified CPR training courses to employees and to individuals who take similar certified CPR education

...consideration of dispatch-assisted CPR instructions from emergency services for bystanders

...the creation of a coalition of stakeholder organizations to spearhead a national public awareness campaign.

"The Heart and Stroke Foundation applauds this initiative," says Manuel Arango, Director, Health Policy, Heart and Stroke Foundation of Canada. "The Foundation is dedicated to strengthening the Chain of Survival™ in communities across Canada." He adds, "Early access to the EMS system through 9-1-1 or local emergency numbers, early CPR, early defibrillation, and early advanced care are essential links in this chain."

"Paramedics often see firsthand the benefits of CPR. We know these patients have the best chance for survival. Paramedics are proud to support the CAEP recommendations for CPR," says Pierre Poirier, Executive Director, Paramedic Association of Canada.

The position paper is available on the CAEP website: www.caep.ca

In addition to Dr. Vaillancourt, members of the CAEP working group that developed the position statement on bystander CPR are: Dr. Norman Epstein, Toronto, ON; Dr. Sheldon Cheskes, Toronto, ON; Dr. Justin Maloney, Ottawa, ON; Dr. Ian. G. Stiell, Ottawa, ON; Dr. James Christenson, Vancouver, BC; Dr. Andrew Affleck, Thunder Bay, ON; Dr. Andrew H. Travers, Dartmouth, NS; Dr. Martin H. Osmond, Ottawa, ON; Patrick Forgie, Peel Region, ON; and Jason Slenys, Peel Region, ON.

As the national voice of Emergency Medicine, CAEP provides continuing medical education and advocates on behalf of emergency physicians and their patients. In cooperation with other specialties and committees, CAEP plays a vital role in the development of national standards and clinical guidelines. For more information: www.caep.ca

Recommendations will Prevent Stroke Patients from Falling Through Cracks

New website provides accessible information on optimal stroke care

OTTAWA, December 8, 2010 /Canada NewsWire/ - The 2010 Canadian Best Practice Recommendations for Stroke Care emphasize the need to prevent stroke patients from falling through the cracks as they move from the ER to in-hospital care to rehabilitation therapy and back to the community. The recommendations were released today by the Canadian Stroke Network and the Heart and Stroke Foundation of Canada.

"The adoption of these best practices will ensure stroke patients and families have rapid and seamless access to appropriate stroke services across the continuum and that they are well supported through these transitions," says Patrice Lindsay, PhD, Director of Performance and Evaluation at the Canadian Stroke Network and one of the project leaders.

Among new recommendations:

...Blood pressure should be maintained at a level that is consistently lower than 140/90;

...Because atrial fibrillation (irregular heartbeat) increases stroke risk, patients with this condition should be closely monitored and the use of new drug therapies should be considered;

...Patients who have a mini-stroke (transient ischemic attack) should be referred immediately to a stroke specialist at a prevention clinic or to an emergency department due to increased risk of a major stroke;

...There should be more widespread use of telestroke - long-distance video and data hookups - between stroke specialists and communities where on-site stroke care does not exist; and
Improved hospital discharge programs are needed, as well as better community services to enable people to return home sooner from hospital.

Thanks to earlier guidelines released in 2006 and 2008, more communities in Canada have an organized emergency response to stroke, stroke prevention clinics, specialized hospital stroke units, and improved rehabilitation services, all of which have been shown to save lives and reduce disability.

This is first time that this information has been pulled together in an easy-to-search and smart-phone friendly website - www.strokebestpractices.ca. The website includes resources to improve stroke and emergency services and to measure their effectiveness. It also includes a patient's guide to optimal stroke care.

"Stroke is the third leading cause of death in Canada yet most strokes are preventable and treatable," says Bobbe Wood, CEO of the Heart and Stroke Foundation of Canada. "Increasing awareness is a key part of the Canadian Stroke Strategy. The best practices website will provide optimal stroke resources and tools to the public and professionals such as physicians, emergency personnel, nurses, rehabilitation specialists and health policymakers."

The Canadian Best Practice Recommendations for Stroke Care was developed as part of the Canadian Stroke Strategy, an initiative of the Canadian Stroke Network and Heart and Stroke Foundation of Canada to improve stroke care for people across the country. There are about 50,000 new strokes in Canada each year and 315,000 Canadians living with the after-effects of a stroke.

The Canadian Stroke Network (canadianstrokenetwork.ca) brings together Canada's leading scientists and clinicians to reduce the physical, social and economic impact of stroke on the lives of individual Canadians and on society as a whole. Headquartered at the University of Ottawa, the Canadian Stroke Network is one of Canada's Networks of Centres of Excellence.

The Heart and Stroke Foundation of Canada (heartandstroke.ca), a volunteer-based health charity, leads in eliminating heart disease and stroke and reducing their impact through the advancement of research and its application, the promotion of healthy living, and advocacy.

The Canadian Stroke Strategy (www.canadianstrokestrategy.ca) is a joint initiative of the Canadian Stroke Network and the Heart and Stroke Foundation of Canada. The goal of the Canadian Stroke Strategy is to help support an integrated approach to stroke prevention, treatment and rehabilitation in every province and territory by 2010.