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

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

Lauri Holmström  1 , Kyndaron Reinier  2 , Lorrel Toft  3 , Henry Halperin  4 , Angelo Salvucci  5 , Jonathan Jui  6 , Sumeet S Chugh  7
Affiliations
Review

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

Lauri Holmström et al. Resuscitation. 2022 Jun.

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.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1 –
Fig. 1 –. Summary of the distinguishing features of EMS-witnessed OHCA.
Fig. 2 –
Fig. 2 –. Prevalence and outcome of initial cardiac rhythms according to OHCA witnessed status.
Fig. 3 –
Fig. 3 –. Schematic illustration of two potential pathways to increase OHCA survival.
See this image and copyright information in PMC

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