1. Fully 50% of men and women in western society with serious coronary artery disease
experience their first signs of the disease in a dramatic way—sudden cardiac arrest.
Whether a victim lives or dies at this point depends on whether the collapse is
witnessed, if the people who are there are trained and WILLING to perform CPR, and
whether the arrest has occurred in a system that can bring about early arrival of
needed resources and execution of evidence based (timely) interventions.
Many have recognized the need to improve community systems of emergency
cardiovascular care to optimize patient survival. The "Chain of Survival" represents the
current approach to improving recognition, response, care and outcomes.
Decades later, this same systematic, organized, coordinated effort in a community
remains the strongest recommendation the resuscitation community can make to save
more people from out-of-hospital cardiac arrest (although I have no business being a
“representative of the collective opinion” of the resuscitation community).
The central question to be answered is whether a community’s system exploits
resources and implements measures and strategies to achieve optimal (and attainable)
patient survival.

2. I find that there are numerous systems where implementation of modifications aimed at
optimizing treatment for patients has lead to improved outcomes for critical out-of-
hospital patients. I believe that concepts and programs such as the Heart Rescue
program and HEARTSafe Communities are essential frameworks for utilization by any
group looking to advance related strategies to improve survival, systems and quality of
life.
Programs like Heart Rescue and HEARTSafe Communities deliver dynamic message of
hope — the hope of saving lives.