The efficacy of an ACLS training program for resuscitation from cardiac arrest in a rural community

Study objective: To determine whether an advanced cardiac life support (ACLS) course in a rural hospital will improve resuscitation success from cardiac arrest. Design: A retrospective case review of all patients in cardiac arrest during a 13-month period before and after the institution of an ACLS training program. Setting: Emergency department of a 42-bed rural, community hospital in a community with no prehospital advanced life support or early defibrillation. Participants: All patients in cardiac arrest were entered into the data base. Twenty-nine patients were included in the pre-ACLS period and 35 in the post-ACLS period. There were no significant differences in age, gender, initial rhythm, comorbid diseases, witnessed versus unwitnessed arrest, or total arrest time in the patients in the pre-ACLS period compared with those in the post-ACLS period. Intervention: ACLS provider training. Main results: Patients in cardiac arrest who had ventricular fibrillation/tachycardia as their initial rhythm had significant improvement in resuscitation success compared with patients in ventricular fibrillation/tachycardia in the pre-ACLS period (six of 15 versus none of nine, P<.05). Out-of-hospital cardiac arrest resuscitation was more successful in the post-ACLS period than in the pre-ACLS period (five of 30 versus none of 25, P<.05). Overall, seven of 35 patients (20%) were resuscitated successfully in the post-ACLS period, with two patients surviving to hospital discharge. This was not significantly different than the two of 29 patients (7%) resuscitated in the pre-ACLS period, with one patient surviving to discharge. Conclusion: The institution of an ACLS-provider course in a rural community hospital was associated with improvement in initial resuscitation for patients with ventricular fibrillation/tachycardia and out-of-hospital arrest.