Heartbeat: improving outcomes after out-of-hospital cardiac arrest

Retrospective study of adults with an OHCA between 2010 and 2019 in Victoria, Australia.1 In the 6050 patients with a shockable rhythm (mean age 60 years, 17% women) 53.1% had a pulse on hospital arrival and 31.1% survived to hospital discharge. Survival was highest with defibrillation by a bystander with an automated external defibrillator (52.8%) compared with defibrillation by first responders (36.7%) or paramedics (27.9%). In the 1520 patients who were interviewed 1 year after the event, most were initially shocked by paramedics (71.6%) or first responders (17.8%). However, the 161 survivors at 1 year initially treated with bystander defibrillation (10.6%) had higher scores on measures of functional and health-related quality of life and were more likely to return to work and live at home without care, compared with those with the initial shock delivered by paramedics. As expected, favourable outcomes were more likely with a shorter time to defibrillation.