Systems with resources available to assist in collection and evaluation of a moderate amount of data can include additional data elements in their registries. A more comprehensive data collection plan is suggested to enable evaluation of care and implementation of improvements to any system. The HeartRescue program has developed a list of data elements which is available online at www.heartrescueproject.com and in the Appendix.
- Receiving hospitals should provide outcome information including survival to admission (yes or no), survival to hospital discharge (yes or no), and if discharged alive, an indication of neurologic status at discharge. The most commonly used scale for measuring neurologic outcome in this population is the cerebral performance category or CPC score (see box). It is widely used because it is relatively simple and can be calculated from information available in the medical record of the patient.
- Hospitals should also provide information about the process of caring for the patient. They should be asked if therapeutic hypothermia was used as well as if the patient received emergency heart catheterization and intervention. Obtaining these measures allows EMS to provide feedback to hospitals to ensure that they are providing optimal care for the patients they receive.
Glasgow-Pittsburgh Cerebral Performance Categories
Good Cerebral Performance
Conscious. Alert, able to work and lead a normal life. May have minor psychological or neurological deficits.
Moderate Cerebral Disability
Conscious. Sufficient cerebral function for part-time work in sheltered environment or independent activities of daily life.
Severe Cerebral Disability
Conscious. Dependent on others for daily support because of impaired brain function (in an institution or at home with exceptional family effort).
Coma, Vegetative State
Not conscious. Unaware of surroundings, no cognition. No verbal or psychological interactions with environment.
Certified brain dead or dead by traditional criteria.2