More from CME in the Tetons: updates in the treatment of cardiac arrest

Gordon A. Ewy, MD, professor of Cardiology at the University of Arizona Health Sciences Center, presented an update on this exciting and evolving field. As I have noted, first here and then in multiple subsequent posts, Ewy and his group have been years ahead of the AHA resuscitation guidelines. The 2005 guidelines, influenced by his work, made new recommendations emphasizing the importance of chest compressions. These recommendations, however only went half way towards full implementation of changes in the treatment of out of hospital cardiac arrest Ewy and his group have been advocating and implementing in some communities since 2003. In those communities, notably areas of Arizona, Wisconsin and greater Kansas City Missouri neurologically intact survival increased to an unprecedented degree.

Here is the paper from Kansas City, the latest community to benefit by a departure from the “evidence based” AHA guidelines. In a related editorial Ewy summarizes recent evidence and suggests a failing of evidence based medicine:

It is always scientifically correct to say that we must wait for randomized controlled trials in humans, but is it always morally correct?

I previously cited the slow progress in resuscitation as a failing of EBM here.