Key result
Bystander CPR and AED use boost out-of-hospital cardiac arrest survival, though regional outcomes vary widely.
Why the study?
Out-of-hospital cardiac arrest remains a major public health challenge with varying outcomes across populations and healthcare systems, motivating a review of evidence across the chain of survival from recognition to long-term recovery.
Does an integrated approach linking community action, dispatcher-assisted CPR, AED accessibility, individualized resuscitation, and post-arrest care improve survival and neurological recovery in patients with out-of-hospital cardiac arrest?
Does an integrated approach linking community action, dispatcher-assisted CPR, AED accessibility, individualized resuscitation, and post-arrest care improve survival and neurological recovery in patients with out-of-hospital cardiac arrest?
Answers are grounded in this paper and cite their sources.
This narrative review highlights significant global and sex-related disparities in out-of-hospital cardiac arrest survival and emphasizes the critical role of standardized registries, bystander CPR, dispatcher assistance, and public AED access in strengthening the chain of survival.
Background: Out-of-hospital cardiac arrest (OHCA) remains a major public health challenge. Survival depends on timely recognition, cardiopulmonary resuscitation (CPR), defibrillation, emergency response, and coordinated post-arrest care. Outcomes vary across populations and healthcare systems. Aim: This review examines evidence on OHCA epidemiology, recognition, prehospital management, individualized resuscitation, in-hospital treatment, and long-term recovery. Methods: Published evidence on cardiac arrest registries, sex-related disparities, dispatcher-assisted CPR, first-responder networks, public education, resuscitation strategies, and post-arrest management was synthesized. System-level barriers and emerging approaches to strengthen the chain of survival were also considered. Results: Registry data demonstrates variation in OHCA incidence, bystander CPR, AED use, and survival between regions. Dispatcher-assisted CPR, trained community responders, accessible AEDs, and public education can strengthen early links in the chain of survival. Women may receive bystander intervention less often, highlighting social and recognition barriers. For refractory ventricular fibrillation, vector-change and double-sequential external defibrillation show potential benefits, although further evidence is needed. In hospitals, temperature control and coronary assessment should reflect clinical presentation. Survivors with non-ischemic causes may require targeted evaluation, including cardiac imaging and genetic assessment. Fatigue, cognitive impairment, and psychological symptoms remain important determinants of functional recovery and quality of life. Conclusion: Improving OHCA outcomes requires an integrated approach linking community action, emergency medical services, individualized resuscitation, evidence-based hospital care, and rehabilitation. Standardized registries, equitable access, and continued research are essential. The review also identifies priorities for equitable implementation and future research.
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Aldhafeeri et al. (2026) conducted a review in Out-of-hospital cardiac arrest (OHCA). Cardiopulmonary resuscitation (CPR), automated external defibrillator (AED) use, and first responder networks was evaluated on Survival to hospital discharge. Bystander CPR and public AED use improve out-of-hospital cardiac arrest survival, which varies across regions from 3.1% to 35%.
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