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How to establish a cardiac arrest registry

The essence of any registry is information. Information to maintain a cardiac arrest registry can come from multiple sources. These include:

1. Dispatch record of time received and dispatch and tape or digital recordings of the call.
2. EMS run reports from EMT and paramedic units including response and arrival times. These may be computerized or paper records and include the flow chart of what therapies were provided and the time as well as the history and ECG findings.
3. AED recordings of the patient’s rhythm and shocks including times. Many AEDs allow for voice recordings
4. Hospital records including whether the patient lived or died and the discharge diagnosis
5. Death certificate in the event the patient died.
6. Phone interview with patient after discharge of surviving spouse or partner. A call to the surviving patient or spouse can reveal useful information about events prior to arrival of the EMS personnel
7. Supplemental information that may be available includes biometric data such as capnography (end tidal CO2)

An EMS agency will not automatically have all the above information. Though I would assume that vital dispatch center information, EMS run reports and AED recordings wuld be readily available. IF this core set of information is not available then one faces a very hard uphill struggle. The most challenging data to obtain come hospitals and vital statistics (the agency that keeps death certificates). The best means to obtain hospital information is to conduct the activity as part of ongoing quality assurance (I prefer the term quality improvement - both are synonymous). In most states it is possible to obtain and record clinical information without obtaining patient consent so long as the information is confidential and part of an ongoing QA/QI activity. As an example, in Washington State the authority to request clinical information is written in state law,

WA State RCW 70.02.050 Disclosure without patient's authorization. (1) A health care provider may disclose health care information about a patient without the patient's authorization to the extent a recipient needs to know the information, if the disclosure is: - To any other person who requires health care information for health care education, or to provide planning, quality assurance, peer review, or administrative, legal, financial, or actuarial services to the health care provider;...