Prehospital Cardiac Arrest Resuscitation Practices Differ Around the Globe
Date
Authors
Kjær, J
Milling, L
Brøchner, AC
Lippert, F
Blomberg, SN
Christensen, HC
Holgate, R
Morrison, LJ
Bakhsh, A
Mikkelsen, S
Supervisor
Item type
Journal Article
Degree name
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier BV
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.Description
Keywords
32 Biomedical and Clinical Sciences, 3201 Cardiovascular Medicine and Haematology, Cardiovascular, Heart Disease, Clinical Research, Generic health relevance, Health system capacity, Termination of resuscitation (TOR), Emergency care disparities, Health policies
Source
Resuscitation Plus, ISSN: 2666-5204 (Print); 2666-5204 (Online), Elsevier BV, 25, 101017-101017. doi: 10.1016/j.resplu.2025.101017
Publisher's version
Rights statement
© 2025 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/ licenses/by/4.0/).