Cardiac arrest & resuscitation
How stepwise interventions in pre-hospital emergency care enhance out-of-hospital cardiac arrest management in a Megacity in China
Authors' conclusion
Stepwise interventions in pre-hospital emergency care increased likelihood of bystander CPR and ROSC following pre-hospital resuscitation significantly.
Study context
- Population
- Emergency medical services (EMS)-treated adult out-of-hospital cardiac arrest (OHCA) patients with presumed cardiac etiology in Shenzhen, China, 2011–2022623 bystander-witnessed, shockable
- Participants
- 6,571 patients
- Exposure
- Sequential stepwise interventions vs pre-intervention period
- Outcome
- Bystander CPR and ROSC
Methodological detailsbefore-after comparison with pre-intervention controls
- Before-after comparison with pre-intervention controls
Main finding
As reported in the abstract
Bystander CPR
Each group vs pre-periodOdds ratio (95% CI)
PAD program
1.64(1.21–2.23)
Civilian CPR training
2.12(1.52–2.95)
T-CPR
3.06(2.14–4.39)
- Bystander cardiopulmonary resuscitation (CPR) rate across the four periods (increasing trend)
- 8.55 vs. 12.60 vs. 18.31 vs. 23.10%
Observational data: associations, not effects.
Further findings
Return of spontaneous circulation (ROSC)
- ROSC rate across the four periods (increasing trend)
- 6.01 vs. 5.29 vs. 9.59 vs. 8.33%
- ROSC with cumulative interventions vs pre-period
- OR 0.84 [95% CI: 0.62-1.14], OR 1.52 [95% CI: 1.07-1.89], OR 1.42 [95% CI: 1.07-1.89]
Subgroups (subgroup analysis)
- Cumulative interventions significantly improved bystander CPR in OHCA in public locations, and ROSC where symptom onset to calling 120 was within 10 min
Original publication
How stepwise interventions in pre-hospital emergency care enhance out-of-hospital cardiac arrest management in a Megacity in China. Resuscitation. Published 26 March 2025. doi:10.
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