Acute cardiac care & 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. This improvement is attributed to the coordination and cumulative effect of multiple positive interventions for OHCA management.
Study context
- Population
- Emergency medical services (EMS)-treated adult out-of-hospital cardiac arrest (OHCA) patients with presumed cardiac etiology in Shenzhen, China, January 1, 2011 to December 31, 2022EMS-treated presumed cardiac etiology adult OHCA patients, 623 cases with bystander-witnessed OHCA and a shockable rhythm
- Participants
- 6,571 patients
- Exposure
- The outcomes of bystander cardiopulmonary resuscitation (CPR) and return of spontaneous circulation (ROSC) were compared with pre-intervention controls.
- Outcome
- Bystander CPR
Main finding
As reported in the abstract
Each group vs pre-periodOdds ratio (95% CI)
PAD program
1.64(1.21–2.23)
Civilian CPR training program
2.12(1.52–2.95)
T-CPR
3.06(2.14–4.39)
Observational data: associations, not effects.
Further findings
| Outcome | Pre-period | PAD program | Civilian CPR training program | T-CPR | OR (95% CI) | |
|---|---|---|---|---|---|---|
| ROSCCivilian CPR training program vs pre-period · cumulative interventions, second OR printed | 6.01% | 5.29% | 9.59% | 8.33% | 1.52 (1.07–1.89) | |
| ROSCCumulative interventions (civilian CPR training program added) vs pre-period | 1.52 (1.07–1.89) | |||||
| 0.512Odds ratio (log scale) |
- ROSC: The abstract prints these three ORs without naming the period each belongs to. They are assigned here in the printed order, by analogy with the bystander CPR sentence; the abstract does not confirm this order.
- ROSC: The second and third ORs carry the same printed CI (1.07-1.89), although their estimates differ (1.52 and 1.42). Copied as printed; check against the full paper.
- ROSC: ROSC — 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)
Subgroup analysis
- Cumulative interventions significantly improved the rate of bystander CPR in cases where OHCA occurred in public locations
- Cumulative interventions significantly improved ROSC in cases where the time from symptom onset to calling 120 was within 10 min
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
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.
Summarised from the published abstract; every number is checked against it