scholarly journals The influence of past experiences on future willingness to perform bystander cardiopulmonary resuscitation

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Keng Sheng Chew ◽  
Shazrina Ahmad Razali ◽  
Shirly Siew Ling Wong ◽  
Aisyah Azizul ◽  
Nurul Faizah Ismail ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Hospital Setting ◽  
Spontaneous Circulation ◽  
Cardiac Events ◽  
Validated Questionnaire ◽  
Bystander Cardiopulmonary Resuscitation ◽  
Past Experiences ◽  
Hospital Cardiac Arrest

Abstract Background The influence of past familial experiences of receiving cardiopulmonary resuscitation (CPR) and medical help in various cardiac arrest and nonfatal cardiac events toward willingness to “pay it forward” by helping the next cardiac arrest victim was explored. Methods Using a validated questionnaire, 6248 participants were asked to rate their willingness to perform bystander chest compression with mouth-to-mouth ventilation and chest compression-only CPR. Their past familial experiences of receiving cardiopulmonary resuscitation (CPR) and medical help in various cardiac arrest and nonfatal cardiac events were also recorded. Results Kruskal-Wallis test with post hoc Dunn’s pairwise comparisons showed that the following were significantly more willing to perform CPR with mouth-to-mouth ventilation: familial experience of “nonfatal cardiac events” (mean rank = 447) vs “out-of-hospital cardiac arrest with no CPR” (mean rank = 177), U = 35442.5, z = −2.055, p = 0.04; “in-hospital cardiac arrest and successful CPR” (mean rank = 2955.79) vs “none of these experiences” (mean rank = 2468.38), U = 111903, z = −2.60, p = 0.01; and “in-hospital cardiac arrest with successful CPR” (mean rank = 133.45) vs “out-of-hospital arrest with no CPR” (mean rank = 112.36), U = 4135.5, z = −2.06, p = 0.04. For compression-only CPR, Kruskal-Wallis test with multiple runs of Mann-Whitney U tests showed that “nonfatal cardiac events” group was statistically higher than the group with “none of these experiences” (mean rank = 3061.43 vs 2859.91), U = 1194658, z = −2.588, p = 0.01. The groups of “in-hospital cardiac arrest with successful CPR” and “in-hospital cardiac arrest with transient return of spontaneous circulation” were the most willing groups to perform compression-only CPR. Conclusion Prior familial experiences of receiving CPR and medical help, particularly among those with successful outcomes in a hospital setting, seem to increase the willingness to perform bystander CPR.

scholarly journals Mechanical Versus Manual Chest Compression: A Retrospective-Cohort in Out-of-Hospital Cardiac Arrest

Acta Medica ◽  
2021 ◽  
pp. 1-7
Author(s):  
Alp Şener ◽  
Gül Pamukçu Günaydın ◽  
Fatih Tanrıverdi
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Survival Rates ◽  
Spontaneous Circulation ◽  
Retrospective Case ◽  
Return Of Spontaneous Circulation ◽  
Mechanical Chest Compression ◽  
Manual Chest Compression ◽  
Hospital Cardiac Arrest

Objective: In cardiac arrest cases, high quality cardiopulmonary resuscitation and effective chest compression are vital issues in improving survival with good neurological outcomes. In this study, we investigated the effect of mechanical chest compression devices on 30- day survival in out-of-hospital cardiac arrest. Materials and Methods: This retrospective case-control study was performed on patients who were over 18 years of age and admitted to the emergency department for cardiac arrest between January 1, 2016 and January 15, 2018. Manual chest compression was performed to the patients before January 15, 2017, and mechanical chest compression was performed after this date. Return of spontaneous circulation, hospital discharge, and 30-day survival rates were compared between the groups of patients in terms of chest compression type. In this study, the LUCAS-2 model piston-based mechanical chest compression device was used for mechanical chest compressions. Results: The rate of return of spontaneous circulation was significantly lower in the mechanical chest compression group (11.1% vs 33.1%; p < 0.001). The 30-day survival rate was higher in the manual chest compression group (6.8% vs 3.7%); however, this difference was not statistically significant (p = 0.542). Furthermore, 30-day survival was 0% in the trauma group and 0.6% in the patient group who underwent cardiopulmonary resuscitation for over 20 minutes. Conclusion: It can be seen that the effect of mechanical chest compression on survival is controversial; studies on this issue should continue and, furthermore, studies on the contribution of mechanical chest compression on labor loss should be conducted.

Resuscitation for Patients with Out-of-Hospital Cardiac Arrest: Singapore

2002 ◽  
Vol 17 (2) ◽  
pp. 96-101 ◽  
Author(s):  
Ghee Hian Lim ◽  
Eillyne Seow
Keyword(s):  
Cardiac Arrest ◽  
Life Support ◽  
Hospital Setting ◽  
Pulseless Electrical Activity ◽  
Spontaneous Circulation ◽  
Very High Frequency ◽  
Traumatic Cardiac Arrest ◽  
Bystander Cardiopulmonary Resuscitation ◽  
Hospital Cardiac Arrest ◽  
Very High

AbstractAim:To evaluate characteristics and outcome of out-of-hospital cardiac arrest (OHCA) patients presenting to the Emergency Department (ED), and to examine factors that could be used to determine to prolong or abort resuscitation for these patients.Method:All OHCA patients presenting to the ED were studied over a three-month period from November 2001 through January 2002. Patient with traumatic cardiac arrest were excluded. Data were collected from the ambulance case records, ED resuscitation charts, and the ED Very High Frequency (VHF) radio case-log sheet. Information collected included the patient's demographic characteristics, timings (time from call to ambulance arrival on scene, time from arrival at scene to departure from scene, time from scene to arrival in the ED) recorded in the pre-hospital setting, the outcome of the resuscitation, and the final outcome for patients who survived ED resuscitation.Results:Ninety-three non-traumatic patients with an OHCA were studied during the three-month period. Of the 93 patients, 15 (16.1%) survived ED resuscitation, and one survived to hospital discharge. There were no statistically significant differences for age, race, or gender with regards to the outcome of the resuscitation. The initial cardiac rhythms were asystole (65), pulseless electrical activity (21), and ventricular fibrillation (7). Fourteen (15%) received bystander cardiopulmonary resuscitation (CPR). All seven patients with return of spontaneous circulation (ROSC) on arrival in the ED survived ED resuscitation. The ambulance took an average of 11.80 ±3.36 minutes for the survivors and 11.8 ±4.22 minutes for the non-survivors from the time of call to get to these patients. The average of the scene times was 12.5 ±4.61 minutes for the survivors and 12.0 ±4.02 minutes for the non-survivors. Transport time from the scene to the ED took an average of 39.1 ±8.32 minutes for the survivors and 37.2 ±9.00 minutes for the non-survivors.Conclusion:The survival rate for patients with OHCA after ED resuscitation is similar to the results from other studies. There is a need to increase the awareness and delivery of basic life support by public education. Automatic External Defibrillators (AED) should be available widely to ensure that the chance of early defibrillation is increased. Prolonged resuscitation efforts appear to be futile for OHCA patients if the time from cardiac arrest until arrival in the ED is ≥30 minutes coupled with no ROSC, and if continuous asystole has been documented for >10 minutes.

Abstract 206: Cardiopulmonary Resuscitation Process Measures Associated With Return of Spontaneous Circulation in Non-Shockable Out-of-Hospital Cardiac Arrest

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Jose M Juarez ◽  
Allison C Koller ◽  
Robert H Schmicker ◽  
Seo Young Park ◽  
David D Salcido ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Duty Cycle ◽  
Spontaneous Circulation ◽  
Research Network ◽  
Process Measures ◽  
Return Of Spontaneous Circulation ◽  
Shockable Rhythm ◽  
Hospital Cardiac Arrest

Purpose: Survival rates after non-shockable out-of-hospital cardiac arrest (OHCA) remain low despite advances in resuscitation. Cardiopulmonary resuscitation (CPR) process measures may inform treatment strategies. We hypothesized that CPR process measures would be associated with return of spontaneous circulation (ROSC) and patient electrocardiogram (ECG) transitions. Methods: We obtained defibrillator monitor data for emergency medical service (EMS)-treated non-shockable OHCA from the Resuscitation Outcomes Consortium (ROC), an OHCA research network (U.S./Canada). We extracted ECG data from EMS defibrillator files and parsed cases into compression-free analyzable segments using custom MATLAB software. Two data abstractors classified segment rhythms as PEA, asystole, ventricular fibrillation (VF), pulseless ventricular tachycardia (PVT), or ROSC. We calculated CPR process measures (average rate, depth, duration, leaning proportion, chest compression fraction, and duty cycle) for CPR bouts preceding every ECG segment. We used mixed effects models controlling for subject to test associations between individual CPR process measures and the bout-level outcomes ROSC and shockable rhythm. Results: We analyzed 1893 cases consisting of 7981 CPR bouts. Case initial rhythms were asystole (68.2%), PEA (24.9%), or NSA-AED (6.9%). Segment rhythm classifications were asystole (78.1%), PEA (20.4%), ROSC (5.5%), VF (1.4%), and PVT (0.07%). Regression model results are shown in Table 1. Chest compression fraction was most strongly associated with ROSC and shockable rhythm. Depth was also associated with shockable rhythm. Leaning proportion and duty cycle were not associated with either outcome. Conclusions: In cases of non-shockable OHCA, CPR quality measures were associated with ROSC and transition to a shockable rhythm at the bout level.

scholarly journals Effect on Chest Compression Fraction of Continuous Manual Compressions with Asynchronous Ventilations Using an i-gel® versus 30:2 Approach during Simulated Out-of-Hospital Cardiac Arrest: Protocol for a Manikin Multicenter Randomized Controlled Trial

Healthcare ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 354
Author(s):  
Loric Stuby ◽  
Laurent Jampen ◽  
Julien Sierro ◽  
Erik Paus ◽  
Thierry Spichiger ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Airway Management ◽  
Chest Compression ◽  
User Satisfaction ◽  
Controlled Trial ◽  
Face Mask ◽  
Spontaneous Circulation ◽  
Multicenter Randomized Controlled Trial ◽  
Hospital Cardiac Arrest

The optimal airway management strategy during cardiopulmonary resuscitation is uncertain. In the case of out-of-hospital cardiac arrest, a high chest compression fraction is paramount to obtain the return of spontaneous circulation and improve survival and neurological outcomes. To improve this fraction, providing continuous chest compressions should be more effective than using the conventional 30:2 ratio. Airway management should, however, be adapted, since face-mask ventilation can hardly be carried out while continuous compressions are administered. The early insertion of a supraglottic device could therefore improve the chest compression fraction by allowing ventilation while maintaining compressions. This is a protocol for a multicenter, parallel, randomized simulation study. Depending on randomization, each team made up of paramedics and emergency medical technicians will manage the 10-min scenario according either to the standard approach (30 compressions with two face-mask ventilations) or to the experimental approach (continuous manual compressions with early insertion of an i-gel® supraglottic device to deliver asynchronous ventilations). The primary outcome will be the chest compression fraction during the first two minutes of cardiopulmonary resuscitation. Secondary outcomes will be chest compression fraction (per cycle and overall), compressions and ventilations quality, time to first shock and to first ventilation, user satisfaction, and providers’ self-assessed cognitive load.

Abstract MP73: Emergency Call First Strategy versus Bystander Cardiopulmonary Resuscitation First Strategy for Out-of-Hospital Cardiac Arrest

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Tatsuma Fukuda ◽  
Naoko Ohashi-Fukuda ◽  
Yutaka Kondo ◽  
Kei Hayashida ◽  
Ichiro Kukita
Keyword(s):  
Overall Survival ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Cerebral Performance Category ◽  
Population Based ◽  
Spontaneous Circulation ◽  
Emergency Call ◽  
Bystander Cardiopulmonary Resuscitation ◽  
Bystander Cpr ◽  
Hospital Cardiac Arrest

Introduction: Lay rescuers have a crucial role in successful cardiopulmonary resuscitation (CPR), specifically the first three links in the chain of survival, for out-of-hospital cardiac arrest (OHCA). However, randomized controlled trials on the priority of emergency call (Call first) versus bystander CPR (CPR first) do not exist, and comparative data are very limited. We aimed to assess the association between the priority of bystander’s action (Call first vs. CPR first) and neurologic outcome after OHCA. Methods: This nationwide population-based study of patients who experienced OHCA from January 2005 to December 2014 was based on the data from the Japanese government-managed registry of OHCA. Patients provided bystander’s action (both emergency call and bystander CPR) within 1 minute of witness were included, and Call first strategy was compared with CPR first strategy. The primary outcome was one-month neurologically favorable survival, defined as a Glasgow-Pittsburgh cerebral performance category (CPC) score of 1(good performance) or 2(moderate disability). The secondary outcomes were prehospital return of spontaneous circulation (ROSC) and one-month overall survival. Results: A total of 25,840 patients were included; 4,430 (17.1%) were treated with Call first approach, and 21,410 (82.9%) were treated with CPR first approach. Among total cohort, 2,696 (10.4%) survived with neurologically favorable status one month after OHCA. In the propensity score-matched cohort, one-month neurologically favorable survival was lower among Call first group compared with CPR first group: 364 of 4,430 patients (8.2%) vs. 457 of 4,430 patients (10.3%), respectively (Risk ratio [RR], 0.80; 95% confidence interval [CI], 0.70-0.91). Similar associations were observed for one-month overall survival (RR, 0.90; 95%CI, 0.82-0.99), although there were no significant differences in prehospital ROSC (RR, 0.94; 95%CI, 0.86-1.02) between the Call first and CPR first groups. In subgroup analyses, the association between delayed bystander CPR and worse neurological outcome did not change regardless of subgroup characteristics. Conclusions: In witnessed OHCA, Call first approach was associated with a decreased chance of one-month neurologically favorable survival compared with CPR first approach. These observational findings warrant a randomized clinical trial to determine the priority of emergency call or bystander CPR for OHCA.

scholarly journals Are Canadians more willing to provide chest-compression-only cardiopulmonary resuscitation (CPR)?—a nation-wide public survey

CJEM ◽  
2015 ◽  
Vol 18 (4) ◽  
pp. 253-263 ◽  
Author(s):  
Lindsay Cheskes ◽  
Laurie J. Morrison ◽  
Dorcas Beaton ◽  
Janet Parsons ◽  
Katie N. Dainty
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Barriers And Facilitators ◽  
Public Knowledge ◽  
Response Distribution ◽  
Public Survey ◽  
Bystander Cardiopulmonary Resuscitation ◽  
Bystander Cpr ◽  
Hospital Cardiac Arrest

AbstractBackgroundBystander cardiopulmonary resuscitation (CPR) improves the likelihood of survival from out-of-hospital cardiac arrest (OHCA), yet it is performed in only 30% of cases. The 2010 guidelines promote chest-compression-only bystander CPR—a change intended to increase willingness to provide CPR.Objectives1) To determine whether the Canadian general public is more willing to perform chest-compression-only CPR compared to traditional CPR; 2) to characterize public knowledge of OHCA; and 3) to identify barriers and facilitators to bystander CPR.MethodsA 32-item survey assessing resuscitation knowledge, and willingness to provide CPR were disseminated in five Canadian regions. Descriptive statistics were used to characterize response distribution. Logistic regression analysis was applied to assess shifts in intention to provide CPR.ResultsA total of 428 completed surveys were analysed. When presented with a scenario of being a bystander in an OHCA, a greater proportion of respondents were willing to provide chest-compression-only CPR compared to traditional CPR for all victims (61.5% v. 39.7%,p<0.001), when the victim was a stranger (55.1% v. 38.8%,p<0.001), or when the victim was an unkempt individual (47.9% v. 28.5%,p<0.001). When asked to describe an OHCA, 41.4% said the heart stopped beating, and 20.8% said it was a heart attack. Identified barriers and facilitators included fear of litigation and lack of skill confidence.ConclusionsThis study identified gaps in knowledge, which may impair the ability of bystanders to act in OHCA. Most respondents expressed greater willingness to provide chest-compression-only CPR, but this was mediated by victim characteristics, skill confidence, and recognition of a cardiac arrest.

scholarly journals Dispatcher-assisted, compression-only bystander cardiopulmonary resuscitation does not improve the outcomes of unwitnessed out-of-hospital cardiac arrest: An observational study with component analysis of rescue breath combination and dispatcher-assisted instruction

2021 ◽  
Author(s):  
Yoshinori Ito ◽  
Hideo Inaba ◽  
Tomoyuki Ushimoto ◽  
Hideki Morita ◽  
Kenshi Murasaka ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Chest Compression ◽  
Significant Interaction ◽  
Univariate Analysis ◽  
Favourable Outcome ◽  
Multivariable Logistic Regression Analysis ◽  
Bystander Cardiopulmonary Resuscitation ◽  
Assisted Instruction ◽  
Hospital Cardiac Arrest

Abstract Objectives: This study aimed to analyse the effects of rescue breath and chest compression combinations in bystander cardiopulmonary resuscitation (BCPR) with and without dispatch-assisted CPR (DA) on the outcomes between unwitnessed and bystander-witnessed out-of-hospital cardiac arrest (OHCA).Design and Settings: This retrospective study analysed the prospectively collected data of 212,003 unwitnessed and 117,920 bystander-witnessed OHCA cases between 2014 and 2016 in Japan, with BCPR classification based on two clinical components (DA provision [with or without DA] and combination of breaths and compressions [standard or compression-only]).Main outcome measures: Neurologically favourable outcome at 1 monthResults: In univariate analysis, unwitnessed cases had no significant association of BCPR with the overall neurologically favourable outcome (provided vs not provided, 0.65% [686/106,152] vs 0.66% [694/105,851]) compared with bystander-witnessed cases (5.6% [3,538/62,814] vs 3.5% [1,911/55,106]). After BCPR classification by two clinical components, the outcome of unwitnessed cases was improved by standard BCPR with DA (0.88% [69/7,807], adjusted OR; 95% CI, 1.38; 1.05–1.81) and compression-only (1.04% [161/15,497], 1.49;1.23–1.80) and standard (1.18% [41/3,463], 1.71; 1.21–2.43) BCPR without DA, but not by compression-only BCPR with DA (0.52% [415/79,385], 0.88; 0.76–1.01). According to multivariable logistic regression analysis focusing on the two clinical components only in cases with BCPR, neurologically favourable outcomes were worse in DA provision (0.76; 0.60–0.97) but better in standard BCPR, (1.27; 1.01–1.60) without significant interaction (P = 0.16), in unwitnessed cases. In bystander-witnessed cases, DA provision was associated with better outcomes (1.27; 1.01–1.60), with significant interaction (P = 0.03).Conclusions: Compared with no BCPR, compression-only BCPR with DA does not improve the neurologically favourable outcomes, and standard BCPR without DA is ideal in unwitnessed OHCA cases. Education on standard CPR and chest compression-only CPR as an option should be maintained because numerous OHCA cases are not witnessed by bystanders.

scholarly journals Gender Based Differences in Outcomes among Resuscitated Patients with Out-of-Hospital Cardiac Arrest

Circulation ◽  
2020 ◽  
Author(s):  
Purav Mody ◽  
Ambarish Pandey ◽  
Arthur S. Slutsky ◽  
Matthew W. Segar ◽  
Alex Kiss ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Spontaneous Circulation ◽  
Do Not Resuscitate ◽  
Logistic Regression Models ◽  
Shockable Rhythm ◽  
Bystander Cardiopulmonary Resuscitation ◽  
Resuscitated Patients ◽  
Gender Based ◽  
Hospital Cardiac Arrest

Background: Studies examining gender-based differences in outcomes of out-of-hospital cardiac arrest patients have demonstrated that despite a higher likelihood of return of spontaneous circulation, women do not have higher survival. Methods: Patients successfully resuscitated from out-of-hospital cardiac arrest enrolled in the Continuous Chest Compression trial were included. Hierarchical multivariable logistic regression models were constructed to evaluate the association between gender and survival after adjustment for age, gender, cardiac arrest rhythm, witnessed status, bystander cardiopulmonary resuscitation, episode location, epinephrine dose, emergency medical services response time and duration of resuscitation. Do Not Resuscitate (DNR) and withdrawal of life-sustaining therapy (WLST) order status were used to assess whether differences in post resuscitation outcomes were modified by baseline prognosis. The analysis was replicated among Amiodarone, Lidocaine, or Placebo Cardiac Arrest trial participants. Results: Among 4,875 successfully resuscitated patients, 1,825 (37.4%) were women and 3,050 (62.6%) were men. Women were older (67.5 vs. 65.3 years), received less bystander cardiopulmonary resuscitation (49.1% vs. 54.9%), and had a lower proportion of cardiac arrests that were witnessed (55.1% vs. 64.5%) or had shockable rhythm (24.3% vs. 44.6%, p<0.001 for all). A significantly higher proportion of women received DNR orders (35.7% vs. 32.1%, p=0.009) and had WLST (32.8% vs. 29.8%, p=0.03). Discharge survival was significantly lower in women (22.5% vs. 36.3%, p<0.001, adjusted odds ratio [OR] 0.78, 95% confidence interval [C.I.] 0.66 - 0.93, p=0.005). The association between gender and discharge survival was modified by DNR and WLST order status such that women had significantly reduced discharge survival among patients who were not made DNR (31.3% vs. 49.9%, p=0.005, adjusted OR 0.74, 95% C.I. 0.60 - 0.91) or did not have WLST (32.3% vs. 50.7%, p=0.002, adjusted OR 0.73, 95% C.I. 0.60 - 0.89). In contrast, no gender difference in survival was noted among patients receiving a DNR order (6.7% vs. 7.4%, p=0.90) or had WLST (2.8% vs. 2.4%, p=0.93). Consistent patterns of association between gender and post-resuscitation outcomes were observed in the secondary cohort. Conclusions: Among resuscitated out-of-hospital cardiac arrest patients, discharge to survival was significantly lower in women compared with men especially among patients considered to have a favorable prognosis.

scholarly journals The Effect of Implementing Mechanical Cardiopulmonary Resuscitation Devices on Out-of-Hospital Cardiac Arrest Patients in an Urban City of Taiwan

2021 ◽  
Vol 18 (7) ◽  
pp. 3636
Author(s):  
Yi-Rong Chen ◽  
Chi-Jiang Liao ◽  
Han-Chun Huang ◽  
Cheng-Han Tsai ◽  
Yao-Sing Su ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Primary Outcome ◽  
Medical Service ◽  
Spontaneous Circulation ◽  
High Quality ◽  
Urban City ◽  
Service Response Time ◽  
Mechanical Cpr ◽  
Hospital Cardiac Arrest

High-quality cardiopulmonary resuscitation (CPR) is a key element in out-of-hospital cardiac arrest (OHCA) resuscitation. Mechanical CPR devices have been developed to provide uninterrupted and high-quality CPR. Although human studies have shown controversial results in favor of mechanical CPR devices, their application in pre-hospital settings continues to increase. There remains scant data on the pre-hospital use of mechanical CPR devices in Asia. Therefore, we conducted a retrospective cohort study between September 2018 and August 2020 in an urban city of Taiwan to analyze the effects of mechanical CPR devices on the outcomes of OHCA; the primary outcome was attainment of return of spontaneous circulation (ROSC). Of 552 patients with OHCA, 279 received mechanical CPR and 273 received manual CPR, before being transferred to the hospital. After multivariate adjustment for the influencing factors, mechanical CPR was independently associated with achievement of any ROSC (OR = 1.871; 95%CI:1.195–2.930) and sustained (≥24 h) ROSC (OR = 2.353; 95%CI:1.427–3.879). Subgroup analyses demonstrated that mechanical CPR is beneficial in shorter emergency medical service response time (≤4 min), witnessed cardiac arrest, and non-shockable cardiac rhythm. These findings support the importance of early EMS activation and high-quality CPR in OHCA resuscitation.

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