Improving Response to Sudden Cardiac Arrest

Promoting best practices in the EMS community

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The Important Role EMS Plays in SCA Response

In 2015, the American Heart Association updated its Guidelines for CPR and Emergency Cardiovascular Care for SCA victims.

They include:

  • Improving the recognition of SCA by 911 call takers and urging 911 call takers to instruct callers to begin chest compressions while awaiting EMS arrival.
  • Providing high-quality CPR with minimal interruptions in chest compressions and with controlled ventilations. Beginning CPR with compressions rather than ventilations (C-A-B instead of A-B-C) to emphasize the primary importance of chest compressions and to decrease barriers to starting CPR.
  • Establishing OHCA Systems of Care — including linking with community AED programs, coordinating with receiving hospitals to optimize post-cardiac arrest care, and measuring survival to hospital discharge.
  • Implementing quantitative waveform capnography for intubated patients to monitor endotracheal tube placement and the quality of the resuscitation.
  • Working as a team during resuscitation with defined roles and clear communication.

Improving EMS System Factors can Improve SCA Outcomes

These factors include:


  • Time to CPR
  • Dispatcher-assisted telephone CPR
  • Recognition of agonal breathing
  • High-performance resuscitation by EMS
  • Community CPR training


  • Time to defibrillation
  • Rapid dispatch
  • Community PAD
  • Police defibrillation


Community SCA Response Planning Guide

For more information, check out the Prehospital Response section of the HeartRescue Community Response Guide.

What if my Community Doesn’t Have the Resources to Implement a Successful SCA Response Program?

While every community has a unique set of circumstances that may not allow for the commitment of resources that top-performing systems may have, similar results can be achieved.

Focusing on best practices does not mean cookie-cutter solutions. Incremental steps can be taken, starting with a number of possibilities including:

  • Measuring OHCA at the basic level (e.g. ventricular fibrillation witnessed arrests)
  • Improving CPR at the EMS level (e.g., implementing high performance CPR education at the EMT level)
  • Implementing public-based CPR/AED education programs
  • Providing 911 dispatchers with SCA recognition training and bystander CPR instructions

How do SCA Survival Rates Reflect the Overall Effectiveness of an EMS System?

There is a correlation between the overall performance of an EMS system and SCA survival rates.

  • The attributes of collaboration and measurement which contribute to good SCA outcomes also contribute to better EMS care in general
  • Collaboration that’s required to improve SCA survival rates means connections between pre-hospital and hospital are strong, which has positive implications for the entire system
  • Undertaking an effort to improve SCA outcomes can have a positive effect on the entire EMS system, in terms of building relationships, cultural changes, and an emphasis on performance and quality improvement