Out-of-hospital cardiac arrest with onset witnessed by emergency medical services: Implications for improvement in overall survival

Lauri Holmström; Kyndaron Reinier; Lorrel Toft; Henry Halperin; Angelo Salvucci; Jonathan Jui; Sumeet S Chugh

doi:10.1016/j.resuscitation.2022.04.003

Out-of-hospital cardiac arrest with onset witnessed by emergency medical services: Implications for improvement in overall survival

Resuscitation. 2022 Jun:175:19-27. doi: 10.1016/j.resuscitation.2022.04.003. Epub 2022 Apr 11.

Authors

Lauri Holmström¹, Kyndaron Reinier², Lorrel Toft³, Henry Halperin⁴, Angelo Salvucci⁵, Jonathan Jui⁶, Sumeet S Chugh⁷

Affiliations

¹ Center for Cardiac Arrest Prevention, Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Health System, Los Angeles, CA, United States; Research Unit of Internal Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.
² Center for Cardiac Arrest Prevention, Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Health System, Los Angeles, CA, United States.
³ Department of Medicine, Cardiology, University of Nevada, Reno School of Medicine, United States.
⁴ Division of Cardiology, The Johns Hopkins University, United States.
⁵ Ventura County Health Care Agency, Ventura, CA, United States.
⁶ Department of Emergency Medicine, Oregon Health and Science University, Portland, OR, United States.
⁷ Center for Cardiac Arrest Prevention, Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Health System, Los Angeles, CA, United States; Division of Artificial Intelligence in Medicine, Department of Medicine, Cedars-Sinai Health System, Los Angeles, CA, United States. Electronic address: sumeet.chugh@cshs.org.

PMID: 35421535
PMCID: PMC10306322
DOI: 10.1016/j.resuscitation.2022.04.003

Abstract

Out-of-hospital cardiac arrest (OHCA) remains a major public health problem. Even in high-income countries, survival rates have plateaued in the range of ten percent, stimulating an ongoing interest in developing novel approaches to resuscitation. Emergency Medical Services (EMS)-witnessed OHCAs constitute a subgroup of overall OHCA that occur after the arrival of EMS, leading to rapid initiation of resuscitation and significantly improved survival. In this narrative review we summarize and interpret recent developments in knowledge of EMS-witnessed OHCA regarding prevalence, demographics, location, circumstances, survival outcomes and clinical profile. We examine the possibility of informing novel resuscitation approaches and enhancing mechanistic knowledge by studying EMS-witnessed OHCA, with the goal of improving overall survival from OHCA.

Keywords: Cardiac arrest; Emergency medical services; Pulseless electrical activity; Sudden cardiac death; Survival; Ventricular fibrillation; Witnessed status.

Publication types

Review
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Cardiopulmonary Resuscitation*
Emergency Medical Services*
Humans
Out-of-Hospital Cardiac Arrest*
Registries
Survival Rate

Abstract

Publication types

MeSH terms

Grants and funding