The Ontario Prehospital Advanced Life Support (OPALS) Study
Background: Sudden cardiac arrest is common and, obviously, very bad. In the US, there are about 500,000 cardiac arrests each year. About half of these cardiac arrests are OHCA and the survival rate is pretty poor. The most recent survival estimates put it at 7 – 9.5% in most communities. About 10-12 years ago, the American Heart Association built the 4-step “chain-of-survival.”
- Step One – Early access to emergency care
- Step Two – Early CPR
- Step Three – Early defibrillation
There is little debate about these three steps as the sum of the data supports that they lead to better outcomes.
The 4th step in the chain, however, is slightly more controversial; early advanced care. This basically means rapid access to ACLS type resuscitation skills (intubation and intravenous drug therapy). Despite it being the 4th step, ACLS has little evidence to defend it. Read more →