Acute cardiac care & resuscitation
Paramedic-assessed quality of bystander CPR is associated with survival in out-of-hospital cardiac arrest
Authors' conclusion
Quality of bCPR is of greater importance than the fact that bCPR was performed. EMS systems and policy-makers should consider measures that support providers of bCPR to deliver effective compressions.
Study context
- Population
- Out-of-hospital cardiac arrest cases in the NSW Ambulance out-of-hospital cardiac arrest (OHCA) registry, 2021–2024patients included
- Participants
- 17,715 cases
- Exposure
- Bystander CPR was included in multivariate models as a dichotomous variable or stratified by Bystander CPR (bCPR) quality, and compared with no bCPR.
- Outcome
- 30-day survival
- Follow-up
- 30 days
Main finding
As reported in the abstract
Each group vs no bCPRAdjusted odds ratio (95% CI)
bCPR
1.70(1.24–2.34)
Good-quality bCPR
2.62(1.86–3.68)
Poor-quality bCPRnot associated with 30-day survival
0.99(0.68–1.45)
Observational data: associations, not effects.
Further findings
Bystander CPR performance and quality recording
- Bystander CPR performed
- 59.4%
- bCPR quality recorded
- 62.1%
Factors associated with bCPR being performed and its quality
- Younger age, witnessed arrest and non-residential location were associated with increased odds of bCPR being performed and being of good quality
- Male sex and EMS response time less than 10 min were associated with lower odds of bCPR being performed but were not associated with quality of bCPR
Original publication
Paramedic-assessed quality of bystander CPR is associated with survival in out-of-hospital cardiac arrest. Resuscitation. Published 26 June 2026. doi:10. 1016/ j. resuscitation. 2026. 111187
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