Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Oct 19;28(1):103.
doi: 10.1186/s13049-020-00798-7.

Description of Emergency Medical Services, treatment of cardiac arrest patients and cardiac arrest registries in Europe

Ingvild B M Tjelmeland  1   2   3 , Siobhan Masterson  4 , Johan Herlitz  5   6 , Jan Wnent  7   8   9 , Leo Bossaert  6   10 , Fernando Rosell-Ortiz  6   11 , Kristin Alm-Kruse  12   13 , Berthold Bein  14   15 , Gisela Lilja  16 , Jan-Thorsten Gräsner  7   6   8 ; GL2020 Epidemiology group and participating countries
Collaborators, Affiliations
Review

Description of Emergency Medical Services, treatment of cardiac arrest patients and cardiac arrest registries in Europe

Ingvild B M Tjelmeland et al. Scand J Trauma Resusc Emerg Med. .

Abstract

Background: Variation in the incidence, survival rate and factors associated with survival after cardiac arrest in Europe is reported. Some studies have tried to fill the knowledge gap regarding the epidemiology of out-of-hospital cardiac arrest in Europe but were unable to identify reasons for the reported differences. Therefore, the purpose of this study was to describe European Emergency Medical Systems, particularly from the perspective of country and ambulance service characteristics, cardiac arrest identification, dispatch, treatment, and monitoring.

Methods: An online questionnaire with 51 questions about ambulance and dispatch characteristics, on-scene management of cardiac arrest and the availability and dataset in cardiac arrest registries, was sent to all national coordinators who participated in the European Registry of Cardiac Arrest studies. In addition, individual invitations were sent to the remaining European countries.

Results: Participants from 28 European countries responded to the questionnaire. Results were combined with official information on population density. Overall, the number of Emergency Medical Service missions, level of training of personnel, availability of Helicopter Emergency Medical Services and the involvement of first responders varied across and within countries. There were similarities in team training, availability of key resuscitation equipment and permission for ongoing performance of cardiopulmonary resuscitation during transported. The quality of reporting to cardiac arrest registries varied, as well as the data availability in the registries.

Conclusions: Throughout Europe there are important differences in Emergency Medical Service systems and the response to out-of-hospital cardiac arrest. Explaining these differences is complicated due to significant variation in how variables are reported to and used in registries.

Keywords: Cardiac arrest registries; Dispatch; Emergency Medical Services (EMS); Epidemiology of cardiac arrest; Out-of-hospital cardiac arrest.

PubMed Disclaimer

Conflict of interest statement

Ingvild Tjelmeland: has nothing to disclose.

Siobhan Masterson: has nothing to disclose.

Johan Herlitz: has nothing to disclose.

Jan Wnent: has no financial COI to be declared. Jan Wnent is member of the steering commitee of the German Resuscitation Registry and member of the EuReCa study managment team.

Leo Bossaert: has nothing to disclose.

Fernando Rossell Ortiz: has nothing to disclose.

Kristin Alm-Kruse: has nothing to disclose.

Berthold Bein: reports personal fees from Edwards Life Sciences, personal fees from CSL Behring, personal fees from Pharmacosmos, personal fees from Ferrer, personal fees from Cytosorbents, personal fees from TEVA Ratiopharm, outside the submitted work.

Gisela Lilja: has nothing to disclose.

Jan-Thorsten Gräsner: reports personal fees and other from Weinmann: Emergency, personal fees and other from Philips Medical, personal fees and other from Fresenius, personal fees from Bard, personal fees and other from Zoll, outside the submitted work.

Figures

Fig. 1
Fig. 1
Population per km2 in Countries Surveyed. Legend: Population density calculated per km2 in relation to total population of the country. The numbers are from the official webpage of the European Union, Europa.eu. * Unite Kingdom excluding Wales
Fig. 2
Fig. 2
Occupation of the majority of employees in the EMS. Legend: The darkest colour indicates countries where the majority of employees are medical doctors, the second darkest colour emergency nurses/nurses, light green indicates paramedics, very light indicates emergency medical technicians and grey is other. White colour indicates the country did not participate in the survey
Fig. 3
Fig. 3
Availability of Helicopter Emergency Medical Services. Legend: Dark blue indicates HEMS 24/7 in all of the country, medium blue indicates HEMS 24/7 in some areas, light blue indicates HEMS but not 24/7 and grey indicates no HEMS. White colour indicates the country did not participate in the survey
Fig. 4
Fig. 4
Out-of-hospital cardiac arrest registries. Legend: The darkest colour indicates a national registry covering all of the country, the second darkest colour indicates a national registry covering parts of the country, medium orange indicates several local registries, light with grey indicates one local registry, grey indicates no local registries and black is unknown. White colour indicates the country did not participate in the survey
See this image and copyright information in PMC

References

    1. Zive DM, Schmicker R, Daya M, Kudenchuk P, Nichol G, Rittenberger JC, et al. Survival and variability over time from out of hospital cardiac arrest across large geographically diverse communities participating in the Resuscitation Outcomes Consortium. Resuscitation. 2018;131:74–82. doi: 10.1016/j.resuscitation.2018.07.023. - DOI - PubMed
    1. Beck B, Bray J, Cameron P, Smith K, Walker T, Grantham H, et al. Regional variation in the characteristics, incidence and outcomes of out-of-hospital cardiac arrest in Australia and New Zealand: results from the Aus-ROC Epistry. Resuscitation. 2018;126:49–57. doi: 10.1016/j.resuscitation.2018.02.029. - DOI - PubMed
    1. Ong MEH, Shin SD, De Souza NNA, Tanaka H, Nishiuchi T, Song KJ, et al. Outcomes for out-of-hospital cardiac arrests across 7 countries in Asia: the Pan Asian Resuscitation Outcomes Study (PAROS) Resuscitation. 2015;96:100–108. doi: 10.1016/j.resuscitation.2015.07.026. - DOI - PubMed
    1. Gräsner J-T, Lefering R, Koster RW, Masterson S, Böttiger BW, Herlitz J, et al. EuReCa ONE; 27 Nations, ONE Europe, ONE Registry. Resuscitation. 2016;105:188–195. doi: 10.1016/j.resuscitation.2016.06.004. - DOI - PubMed
    1. Gräsner J-T, Wnent J, Herlitz J, Perkins GD, Lefering R, Tjelmeland I, et al. Survival after out-of-hospital cardiac arrest in Europe - results of the EuReCa TWO study. Resuscitation. 2020;148:218–226. doi: 10.1016/j.resuscitation.2019.12.042. - DOI - PubMed

MeSH terms