Identifying strategies to improve survival from out-of-hospital cardiac arrest

Associate Professor Janet Bray, Monash University

2019 Vanguard Grant

Years funded: 2020-2022

Out-of-hospital cardiac arrest (OHCA) is a significant public health issue. In Australia and New Zealand, as many as 30,000 OHCA occur every year with only 12% surviving. OHCA survival increases when the OHCA is quickly recognised, an ambulance is called, CPR is commenced, rapid ambulance treatment is provided and the patient is transported to a hospital that can provide post-resuscitation care. These elements form links in what is known as the Chain of Survival.

The first data from the Australian Resuscitation Outcomes Consortium (Aus-ROC) OHCA Registry suggests there is significant regional variation in survival across Australia states and regions of New Zealand (ranging from 9% to 17%). Understanding why this regional variation is occurring is key to driving changes in policy and practice to reduce health inequities and improve OHCA outcomes.

This study aims to identify key factors underpinning the variation in survival seen across Australia and New Zealand, and make recommendations for interventions. Specifically, to study the impact of variation in the key links in the Chain of Survival at the:

1. community level (identification of OHCA in the emergency call and bystander CPR);
2. ambulance service level (timing of ambulance care);
3. health service level (receiving hospital characteristics).

Only through identifying sub-optimal performance in each component of care provided to OHCA patients can we develop strategies to improve patient outcomes.