Bystander availability, CPR uptake, and AED use during out-of-hospital cardiac arrest.
Resuscitation Plus · 2025-04-30 · Observational study
Abstract
BACKGROUND: Bystander cardiopulmonary resuscitation (CPR) and defibrillation of a shockable rhythm improve survival following out-of-hospital cardiac arrest (OHCA). Little data exists on bystander participation during genuine cardiac arrest calls. METHOD: This was a prospective audit of bystander participation during OHCA calls to a single ambulance service in the United Kingdom. A convenience sample of consecutive OHCA calls from March 2022 until April 2023, where an adult cardiac arrest was confirmed and CPR was advised, was audited by a call handler. Cases with a valid do not attempt CPR decision were excluded. Data on key time intervals and bystander participation were extracted and analysed in R (v4.2). RESULTS: In total, 451 cases were analysed. Median time until cardiac arrest recognition was 42 s (IQR 94.7 s) and until the initiation of CPR was 161 s (IQR 124 s). A lone bystander was present in 162 (35.9%) cases, two bystanders in 149 (33.0%) cases, and three or more bystanders in 140 (31.0%) cases. CPR was attempted by a bystander in 382 (84.7%) cases. Physical inability, refusal, and inability to correctly position patient were common reasons for not performing CPR. A defibrillator was retrieved before the arrival of emergency medical services in 36 (8%) cases and a shock was administered in 9 (2%) cases, while a shock was not advised in 20 (4%) further cases. CONCLUSION: Cardiac arrest was identified rapidly but there was a delay to initiation of CPR. A lone bystander was present in over one third of cases, eliminating the possibility of bystander defibrillation in the absence of a lay first responder.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Automated external defibrillator · Bystanders · Dispatchers & call takers · Time intervals
Related articles
- Factors Associated with the Application of Automated External Defibrillators to Out-of-Hospital Cardiac Arrest Patients in Japan - A Nationwide Cross-Sectional Study. (Prehosp Emerg Care, 2026)
- The use of drone-delivered Automated External Defibrillators in the emergency response for out-of-hospital cardiac arrest. A simulation study. (Resusc Plus, 2025)
- Ventricular fibrillation in King County, Washington: a 30-year perspective. (Resuscitation, 2008)
- Performance of cellular phones with video telephony in the use of automated external defibrillators by untrained laypersons. (Emerg Med J, 2008)
- Effect of a smartphone application on dispatcher-assisted CPR and AED response in simulated out-of-hospital cardiac arrest. (Resusc Plus, 2026)
- Incidence, process of care, and outcomes of out-of-hospital cardiac arrest in China: a prospective study of the BASIC-OHCA registry. (Lancet Public Health, 2023)