Prehospital cardiac arrest resuscitation practices differ around the globe.
Journal
Resuscitation plus
Journal Volume
25
Start Page
101017
ISSN
2666-5204
Date Issued
2025-09
Author(s)
Kjær, Jeannett
Milling, Louise
Brøchner, Anne Craveiro
Lippert, Freddy
Blomberg, Stig Nikolaj
Christensen, Helle Collatz
Holgate, Robyn
Morrison, Laurie J
Bakhsh, Abdullah
Mikkelsen, Søren
et al.
Abstract
Background: Out-of-hospital cardiac arrest (OHCA) is a major public health problem. This study aims to describe the international variations in the practices related to the initiation, termination, and refraining from resuscitation of adult patients (≥18 years) with a non-traumatic OHCA. Methods: An exploratory descriptive study was conducted using a cross-sectional online survey. The respondents were recruited using snowball sampling technique. Framework analysis was used to identify key themes in responses, with descriptive statistics summarising data trends. Results: The study collected responses from 59 countries. Our findings reveal that respondents from 59.3% of countries reported that they initiate resuscitation in all cases where the patients do not show obvious signs of irreversible death or do not have confirmed advance directives. Respondents from 15.3% of countries reported that once started, prehospital resuscitation attempts are not terminated. Prehospitally respondents from 20.3% of the countries reported that they rely exclusively on specific criteria to decide when to terminate resuscitation efforts while in 45.8%, these decisions are made at the discretion of the provider. Respondents from most countries (91.5%) reported that they refrain from resuscitation in the presence of obvious signs of irreversible death. Respondents from 57.6% of countries, reported that they refrained from resuscitation if the patient had a confirmed do-not-attempt-cardiopulmonaryresuscitation (DNACPR), while 15.3% mentioned staff safety as a reason to abstain from attempting resuscitation. Conclusion: This study reveals global variation in EMS resuscitation practices, reflecting disparities in resources, healthcare infrastructure, EMS system design, community acceptability given cultural and societal norms, and legislation.
Subjects
Emergency care disparities
Health policies
Health system capacity
Termination of resuscitation (TOR)
Publisher
Elsevier B.V.
Type
journal article