Prehospital cardiac arrest resuscitation practices differ around the globe

Kjær J.; Milling L.; Brøchner A.C.; Lippert F.; Blomberg S.N.; Christensen H.C.; Holgate R.; Morrison L.J.; Bakhsh A.; Mikkelsen S.; Alsulimani L.K.; Popela S.; Vidunová J.K.; Peran D.; Gregor R.; Papousek R.; Simić A.; Cairol A.; Ingelmo V.S.-B.; Björnsson H.M.; Stammet P.; Escalante-Kanashiro R.; Nikolaidou O.; Karageorgos V.; Aslanidis T.; Wallner B.; Rief M.; Eichinger M.; Chakra Rao S.S.C.; SinghMD B.; Birkun A.A.; Aguilera P.; Bakker J.; Zaher M.S.; Alwajeeh S.A.; Tanabe S.; Iwami T.; Saito S.; Fraga-Sastrias J.-M.; Kittivo J.E.; Achiro K.O.; Ndinda C.; Monsieurs K.; Snijders E.; Abdullah N.; Stanton D.; Meyer J.T.; Crawford S.J.; Loghmari D.; Turkia H.B.; Barbaria W.; Wijesuriya N.; Dilruk Indika Rathnayake R.M.; Woltman N.; Mesa-Gaerlan F.J.; Convocar P.; Velasco B.P.; Alihodžić H.; Alrawashdeh A.; Alwidyan M.T.; Soares-Oliveira M.; Mota M.; Cao Y.; Yao P.; Kin Lam R.P.; Cheung A.C.-K.; Bogár B.; Temesvari P.; Gebei R.; Karaaslan P.; Sofuoglu T.; Ciocan L.; Jaeger D.; Sung C.-W.; Chen C.-H.; Gellerfors M.; Wahlin R.R.; Schell C.O.; Gardiner F.; Nichols M.; Perillo S.; Reid D.; Mohrsen S.; Corfield A.R.; Allen M.; Falcetta S.; Menarini M.; Rehn M.; Kramer-Johansen J.; Bredmose P.P.; Olasveengen T.M.; Uleberg O.; Wilson T.; Lindner T.W.; Jacobsen L.; Formo A.; Elden T.; Olsen M.S.; Kowalski M.; Derkowski T.; Hansen P.M.; Hansen T.M.; Rognås L.; Steinmetz J.; Bøtker M.T.; Lunen T.B.; Wemmelund H.; Carron P.-N.; Suppan L.; DeVries R.A.; Froelich E.; Thornton T.; Brent C.; Wayne M.; Sayre M.R.; Job G.; Ferguson J.D.; Perina D.; Lane C.J.; Miller K.; Fritz C.; DeWall J.; Stilley J.; Cornelius A.P.; Jarvis J.L.; Wu E.; Bernhardson N.; Katz R.; Corsa J.G.; Gruzd D.C.; Wentling J.; Goodloe J.M.; Zozula A.; Holley J.E.; Vetrano S.J.; LoConte M.; Darsey D.; Lybeck A.; Chassee T.; Björkman J.; Nurmi J.; Iirola T.; Jäntti H.; Kurola J.; Reifferscheid F.; Rudolph M.; Hilbert-Carius P.; Katzenschlager S.; Barten D.G.; Tan E.C.T.H.; Benno Berg I.T.; van Geffen G.-J.; Seesink J.; van der Ploeg G.-J.; Anderson N.; Swain A.H.; Wah Ho A.F.; Yong Ivan C.S.; von Vopelius-Feldt J.; MacDonald R.D.; Ssewanyana J.; Krasniqi A.; Simon D.; Kanu U.; Farrugia R.B.; Ek J.E.; Soldat M.B.; Michagin G.; Bach V.; Lohse N.; Morais D.A.; Alinier G.; Romero R.M.; Ahn K.-O.; Strnad M.; Noc M.; Lesjak V.B.; Markota A.; Phungoen P.; Apiratwarakul K.; Masterson S.; O'Donnell C.; Zul J.; Naval Potro Pascual J.M.; Louis C.J.; Burket G., III · Resuscitation Plus (2025) · DOI: 10.1016/j.resplu.2025.101017

Resumen

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.

Instituciones: Universidad Peruana de Ciencias Aplicadas