Does resuscitation training affect outcome from cardiac arrest?

It is established that basic life support (BLS) is performed inadequately by both nursing and medical staff and that the ability to retain these skills, once trained, is low. In addition, the initial success rate from cardiopulmonary arrest is poor. By implementing the advanced life support (ALS) course and providing frequent updates on resuscitation skills and management, it is expected that cardiac arrest outcome results should improve. This data is from a 4 year audit of in-hospital cardiac arrest within an adult patient group between January 1993 and December 1996. The average return response of all audit forms was 86.5%. The total sample consisted of 367 separate arrests where the initial rhythm was documented as either ventricular fibrillation (VF)/ventricular tachycardia (VT) (58.3%), asystole (21.7%), electromechanical dissociation (EMD) (7.0%) and other (13.0%). Initial success was defined as return of spontaneous circulation (ROSC). This was achieved in 75.0% of all resuscitation attempts. Within the VF/VT group, successful outcome remained consistent over the 4-year period with an ROSC of 85%. Successful outcome remained consistent in the EMD group, however, the number of arrests was small. Within the asystole group, initial survival increased from 47.5% in 1993-1994 to 67.5% in 1995-1996. These results suggest that BLS and ALS training may only have an impact on initial survival from cardiac arrest.