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Even After Death, Heart Attack Treatment May Not End
Date:6/30/2009

Too often, EMS crews feel obliged to bring unresponsive patient to hospital, study finds

TUESDAY, June 30 (HealthDay News) -- Chances of surviving a heart attack that occurs outside of a hospital are slim, but paramedics often take people who have died to a hospital anyway because a variety of factors keep them from following recommended guidelines, a new study finds.

In the United States, paramedics treat almost 300,000 people with cardiac arrest each year. But despite what's portrayed on TV, fewer than 8 percent survive, according to the American Heart Association.

The association's guidelines include the recommendation that people who have not responded to cardiopulmonary resuscitation (CPR) and advanced cardiac life support in the field not be taken to a hospital. After paramedics have tried and failed to resuscitate a patient, they should stop, researchers say.

"Paramedics provide all the same lifesaving procedures that we can provide in the emergency department," said the study's lead researcher, Dr. Comilla Sasson, Robert Wood Johnson clinical scholar and clinical lecturer in emergency medicine at the University of Michigan Medical School.

"Once you have done 20 to 30 minutes of cardiac resuscitation, the best practice guidelines are to cease if a patient does not have a pulse," she said. But the study, published online June 30 in Circulation: Cardiovascular Quality and Outcomes, found that several factors inhibit this from happening, including:

  • Local laws that mandate procedures for paramedics and other responders
  • Insurance policies that allow higher reimbursement when someone is taken to a hospital
  • Public misperception about the odds of survival

"When you look at TV shows, 90 to 95 percent of the people survive cardiac arrest," Sasson said. "In reality, it's less than 8 percent, so there is a big disconnect about what people understand a
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