Cardiac Arrest Awareness

We propose a two year multicenter observational study of 900-1500 patients experiencing cardiac arrests. Cardiac arrest is defined as the cessation of heartbeat and respiration [the heart stops pumping blood causing sudden collapse and absence of breathing]. These patients need cardiopulmonary resuscitation [CPR] which is delivered as chest compressions from a rescuer or mechanical device with artificial breathing. These measures can avert death and allow potential for survival. A number of recent studies have indicated that 10% of cardiac arrest survivors report memories and thought processes from their period of resuscitation. A small proportion of survivors have also described the ability to “see” and “hear” details of their cardiac arrest. The significance and mechanisms that lead to these experiences are not fully understood – we do not know if they matter or why they happen. It is possible that patients who are able to recount these experiences may have better patient outcomes in terms of reduced brain damage, improved functional ability and better psychological adjustment to the event. We think that these patients may have had better blood flow to the brain during cardiac arrest, leading to consciousness and activity of the mind. Our target population is patients experiencing cardiac arrest in hospital [in the emergency department or hospital wards] or out of hospital [in whom resuscitation efforts are ongoing at ED arrival]. Emergency Department or Research staff will be alerted to cardiac arrest and will attend with portable brain oxygen monitoring devices and a tablet which will display visual images upwards above the patient as resuscitation is taking place. Measurements obtained during cardiac arrest will be used to compare data from all cardiac arrest patients independent of outcome [whether they live or die]. Survivors will then be followed up and with their consent will have in-depth, audio recorded interviews.