Prehospital cardiac arrest resuscitation practices differ around the globe

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Background: Out-of-hospital cardiac arrest (OHCA) is a major public health problem. This study aims to describe the international variations in the practices related to the initiation, termination, and refraining from resuscitation of adult patients (≥18 years) with a non-traumatic OHCA. Methods: An...

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Autores: Kjær, Jeannett, Milling, Louise, Brøchner, Anne Craveiro, Lippert, Freddy, Blomberg, Stig Nikolaj, Christensen, Helle Collatz, Holgate, Robyn, Morrison, Laurie J., Bakhsh, Abdullah, Mikkelsen, Søren, Alsulimani, Loui K., Popela, Stanislav, Vidunová, Jana Kruba, Peran, David, Gregor, Roman, Papousek, René, Simić, Anđela, Cairol, Andrés, Ingelmo, Vicente Sánchez Brunete, Björnsson, Hjalti Már, Stammet, Pascal, Escalante-Kanashiro, Raffo, Nikolaidou, Olympia, Karageorgos, Vlasios, Aslanidis, Theodoros, Wallner, Bernd, Rief, Martin, Eichinger, Michael, Chakra Rao, Siddha S.C., SinghMD, Baljit, Birkun, Alexei A., Aguilera, Pablo, Bakker, Jan, Zaher, Muhammad Sultan, Alwajeeh, Sultan Ali, Tanabe, Seizan, Iwami, Taku, Saito, Shunsuke, Fraga-Sastrias, Juan Manuel, Kittivo, June Eva, Achiro, Kephas Ochieng, Ndinda, Caroline, Monsieurs, Koen, Snijders, Erwin, Abdullah, Naseef, Stanton, David, Meyer, John Thomas, Crawford, Steven John, Loghmari, Dorra, Turkia, Hela ben, Barbaria, Wiem, Wijesuriya, Nilmini, Dilruk Indika Rathnayake, Rathnayake Mudiyanselage, Woltman, Nathan, Mesa-Gaerlan, Faith Joan, Convocar, Pauline, Velasco, Bernadett Pua, Alihodžić, Hajriz, Alrawashdeh, Ahmad, Alwidyan, Mahmoud T., Soares-Oliveira, Miguel, Mota, Mauro, Cao, Yu, Yao, Peng, Kin Lam, Rex Pui, Cheung, Arthur Chi Kin, Bogár, Bence, Temesvari, Peter, Gebei, Róbert, Karaaslan, Pelin, Sofuoglu, Turhan, Ciocan, Liviu, Jaeger, Déborah, Sung, Chih Wei, Chen, Chi Hsin, Gellerfors, Mikael, Wahlin, Rebecka Rubenson, Schell, Carl Otto, Gardiner, Fergus, Nichols, Martin, Perillo, Sam, Reid, David, Mohrsen, Stian, Corfield, Alasdair R., Allen, Marc, Falcetta, Stefano, Menarini, Maurizio, Rehn, Marius, Kramer-Johansen, Jo, Bredmose, Per P., Olasveengen, Theresa Mariero, Uleberg, Oddvar, Wilson, Thomas, Lindner, Thomas W., Jacobsen, Lars, Formo, Amund, Elden, Trond, Olsen, Mari Stokstad, Kowalski, Marcin, Derkowski, Tomasz
Formato: artículo
Fecha de Publicación:2025
Institución:Universidad Peruana de Ciencias Aplicadas
Repositorio:UPC-Institucional
Lenguaje:inglés
OAI Identifier:oai:repositorioacademico.upc.edu.pe:10757/686704
Enlace del recurso:http://hdl.handle.net/10757/686704
Nivel de acceso:acceso abierto
Materia:Emergency care disparities
Health policies
Health system capacity
Termination of resuscitation (TOR)
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dc.title.es_PE.fl_str_mv Prehospital cardiac arrest resuscitation practices differ around the globe
title Prehospital cardiac arrest resuscitation practices differ around the globe
spellingShingle Prehospital cardiac arrest resuscitation practices differ around the globe
Kjær, Jeannett
Emergency care disparities
Health policies
Health system capacity
Termination of resuscitation (TOR)
title_short Prehospital cardiac arrest resuscitation practices differ around the globe
title_full Prehospital cardiac arrest resuscitation practices differ around the globe
title_fullStr Prehospital cardiac arrest resuscitation practices differ around the globe
title_full_unstemmed Prehospital cardiac arrest resuscitation practices differ around the globe
title_sort Prehospital cardiac arrest resuscitation practices differ around the globe
author Kjær, Jeannett
author_facet Kjær, Jeannett
Milling, Louise
Brøchner, Anne Craveiro
Lippert, Freddy
Blomberg, Stig Nikolaj
Christensen, Helle Collatz
Holgate, Robyn
Morrison, Laurie J.
Bakhsh, Abdullah
Mikkelsen, Søren
Alsulimani, Loui K.
Popela, Stanislav
Vidunová, Jana Kruba
Peran, David
Gregor, Roman
Papousek, René
Simić, Anđela
Cairol, Andrés
Ingelmo, Vicente Sánchez Brunete
Björnsson, Hjalti Már
Stammet, Pascal
Escalante-Kanashiro, Raffo
Nikolaidou, Olympia
Karageorgos, Vlasios
Aslanidis, Theodoros
Wallner, Bernd
Rief, Martin
Eichinger, Michael
Chakra Rao, Siddha S.C.
SinghMD, Baljit
Birkun, Alexei A.
Aguilera, Pablo
Bakker, Jan
Zaher, Muhammad Sultan
Alwajeeh, Sultan Ali
Tanabe, Seizan
Iwami, Taku
Saito, Shunsuke
Fraga-Sastrias, Juan Manuel
Kittivo, June Eva
Achiro, Kephas Ochieng
Ndinda, Caroline
Monsieurs, Koen
Snijders, Erwin
Abdullah, Naseef
Stanton, David
Meyer, John Thomas
Crawford, Steven John
Loghmari, Dorra
Turkia, Hela ben
Barbaria, Wiem
Wijesuriya, Nilmini
Dilruk Indika Rathnayake, Rathnayake Mudiyanselage
Woltman, Nathan
Mesa-Gaerlan, Faith Joan
Convocar, Pauline
Velasco, Bernadett Pua
Alihodžić, Hajriz
Alrawashdeh, Ahmad
Alwidyan, Mahmoud T.
Soares-Oliveira, Miguel
Mota, Mauro
Cao, Yu
Yao, Peng
Kin Lam, Rex Pui
Cheung, Arthur Chi Kin
Bogár, Bence
Temesvari, Peter
Gebei, Róbert
Karaaslan, Pelin
Sofuoglu, Turhan
Ciocan, Liviu
Jaeger, Déborah
Sung, Chih Wei
Chen, Chi Hsin
Gellerfors, Mikael
Wahlin, Rebecka Rubenson
Schell, Carl Otto
Gardiner, Fergus
Nichols, Martin
Perillo, Sam
Reid, David
Mohrsen, Stian
Corfield, Alasdair R.
Allen, Marc
Falcetta, Stefano
Menarini, Maurizio
Rehn, Marius
Kramer-Johansen, Jo
Bredmose, Per P.
Olasveengen, Theresa Mariero
Uleberg, Oddvar
Wilson, Thomas
Lindner, Thomas W.
Jacobsen, Lars
Formo, Amund
Elden, Trond
Olsen, Mari Stokstad
Kowalski, Marcin
Derkowski, Tomasz
author_role author
author2 Milling, Louise
Brøchner, Anne Craveiro
Lippert, Freddy
Blomberg, Stig Nikolaj
Christensen, Helle Collatz
Holgate, Robyn
Morrison, Laurie J.
Bakhsh, Abdullah
Mikkelsen, Søren
Alsulimani, Loui K.
Popela, Stanislav
Vidunová, Jana Kruba
Peran, David
Gregor, Roman
Papousek, René
Simić, Anđela
Cairol, Andrés
Ingelmo, Vicente Sánchez Brunete
Björnsson, Hjalti Már
Stammet, Pascal
Escalante-Kanashiro, Raffo
Nikolaidou, Olympia
Karageorgos, Vlasios
Aslanidis, Theodoros
Wallner, Bernd
Rief, Martin
Eichinger, Michael
Chakra Rao, Siddha S.C.
SinghMD, Baljit
Birkun, Alexei A.
Aguilera, Pablo
Bakker, Jan
Zaher, Muhammad Sultan
Alwajeeh, Sultan Ali
Tanabe, Seizan
Iwami, Taku
Saito, Shunsuke
Fraga-Sastrias, Juan Manuel
Kittivo, June Eva
Achiro, Kephas Ochieng
Ndinda, Caroline
Monsieurs, Koen
Snijders, Erwin
Abdullah, Naseef
Stanton, David
Meyer, John Thomas
Crawford, Steven John
Loghmari, Dorra
Turkia, Hela ben
Barbaria, Wiem
Wijesuriya, Nilmini
Dilruk Indika Rathnayake, Rathnayake Mudiyanselage
Woltman, Nathan
Mesa-Gaerlan, Faith Joan
Convocar, Pauline
Velasco, Bernadett Pua
Alihodžić, Hajriz
Alrawashdeh, Ahmad
Alwidyan, Mahmoud T.
Soares-Oliveira, Miguel
Mota, Mauro
Cao, Yu
Yao, Peng
Kin Lam, Rex Pui
Cheung, Arthur Chi Kin
Bogár, Bence
Temesvari, Peter
Gebei, Róbert
Karaaslan, Pelin
Sofuoglu, Turhan
Ciocan, Liviu
Jaeger, Déborah
Sung, Chih Wei
Chen, Chi Hsin
Gellerfors, Mikael
Wahlin, Rebecka Rubenson
Schell, Carl Otto
Gardiner, Fergus
Nichols, Martin
Perillo, Sam
Reid, David
Mohrsen, Stian
Corfield, Alasdair R.
Allen, Marc
Falcetta, Stefano
Menarini, Maurizio
Rehn, Marius
Kramer-Johansen, Jo
Bredmose, Per P.
Olasveengen, Theresa Mariero
Uleberg, Oddvar
Wilson, Thomas
Lindner, Thomas W.
Jacobsen, Lars
Formo, Amund
Elden, Trond
Olsen, Mari Stokstad
Kowalski, Marcin
Derkowski, Tomasz
author2_role author
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dc.contributor.author.fl_str_mv Kjær, Jeannett
Milling, Louise
Brøchner, Anne Craveiro
Lippert, Freddy
Blomberg, Stig Nikolaj
Christensen, Helle Collatz
Holgate, Robyn
Morrison, Laurie J.
Bakhsh, Abdullah
Mikkelsen, Søren
Alsulimani, Loui K.
Popela, Stanislav
Vidunová, Jana Kruba
Peran, David
Gregor, Roman
Papousek, René
Simić, Anđela
Cairol, Andrés
Ingelmo, Vicente Sánchez Brunete
Björnsson, Hjalti Már
Stammet, Pascal
Escalante-Kanashiro, Raffo
Nikolaidou, Olympia
Karageorgos, Vlasios
Aslanidis, Theodoros
Wallner, Bernd
Rief, Martin
Eichinger, Michael
Chakra Rao, Siddha S.C.
SinghMD, Baljit
Birkun, Alexei A.
Aguilera, Pablo
Bakker, Jan
Zaher, Muhammad Sultan
Alwajeeh, Sultan Ali
Tanabe, Seizan
Iwami, Taku
Saito, Shunsuke
Fraga-Sastrias, Juan Manuel
Kittivo, June Eva
Achiro, Kephas Ochieng
Ndinda, Caroline
Monsieurs, Koen
Snijders, Erwin
Abdullah, Naseef
Stanton, David
Meyer, John Thomas
Crawford, Steven John
Loghmari, Dorra
Turkia, Hela ben
Barbaria, Wiem
Wijesuriya, Nilmini
Dilruk Indika Rathnayake, Rathnayake Mudiyanselage
Woltman, Nathan
Mesa-Gaerlan, Faith Joan
Convocar, Pauline
Velasco, Bernadett Pua
Alihodžić, Hajriz
Alrawashdeh, Ahmad
Alwidyan, Mahmoud T.
Soares-Oliveira, Miguel
Mota, Mauro
Cao, Yu
Yao, Peng
Kin Lam, Rex Pui
Cheung, Arthur Chi Kin
Bogár, Bence
Temesvari, Peter
Gebei, Róbert
Karaaslan, Pelin
Sofuoglu, Turhan
Ciocan, Liviu
Jaeger, Déborah
Sung, Chih Wei
Chen, Chi Hsin
Gellerfors, Mikael
Wahlin, Rebecka Rubenson
Schell, Carl Otto
Gardiner, Fergus
Nichols, Martin
Perillo, Sam
Reid, David
Mohrsen, Stian
Corfield, Alasdair R.
Allen, Marc
Falcetta, Stefano
Menarini, Maurizio
Rehn, Marius
Kramer-Johansen, Jo
Bredmose, Per P.
Olasveengen, Theresa Mariero
Uleberg, Oddvar
Wilson, Thomas
Lindner, Thomas W.
Jacobsen, Lars
Formo, Amund
Elden, Trond
Olsen, Mari Stokstad
Kowalski, Marcin
Derkowski, Tomasz
dc.subject.es_PE.fl_str_mv Emergency care disparities
Health policies
Health system capacity
Termination of resuscitation (TOR)
topic Emergency care disparities
Health policies
Health system capacity
Termination of resuscitation (TOR)
description Background: Out-of-hospital cardiac arrest (OHCA) is a major public health problem. This study aims to describe the international variations in the practices related to the initiation, termination, and refraining from resuscitation of adult patients (≥18 years) with a non-traumatic OHCA. Methods: An exploratory descriptive study was conducted using a cross-sectional online survey. The respondents were recruited using snowball sampling technique. Framework analysis was used to identify key themes in responses, with descriptive statistics summarising data trends. Results: The study collected responses from 59 countries. Our findings reveal that respondents from 59.3% of countries reported that they initiate resuscitation in all cases where the patients do not show obvious signs of irreversible death or do not have confirmed advance directives. Respondents from 15.3% of countries reported that once started, prehospital resuscitation attempts are not terminated. Prehospitally respondents from 20.3% of the countries reported that they rely exclusively on specific criteria to decide when to terminate resuscitation efforts while in 45.8%, these decisions are made at the discretion of the provider. Respondents from most countries (91.5%) reported that they refrain from resuscitation in the presence of obvious signs of irreversible death. Respondents from 57.6% of countries, reported that they refrained from resuscitation if the patient had a confirmed do-not-attempt-cardiopulmonaryresuscitation (DNACPR), while 15.3% mentioned staff safety as a reason to abstain from attempting resuscitation. Conclusion: This study reveals global variation in EMS resuscitation practices, reflecting disparities in resources, healthcare infrastructure, EMS system design, community acceptability given cultural and societal norms, and legislation.
publishDate 2025
dc.date.accessioned.none.fl_str_mv 2025-09-18T03:31:03Z
dc.date.available.none.fl_str_mv 2025-09-18T03:31:03Z
dc.date.issued.fl_str_mv 2025-09-01
dc.type.es_PE.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.doi.none.fl_str_mv 10.1016/j.resplu.2025.101017
dc.identifier.uri.none.fl_str_mv http://hdl.handle.net/10757/686704
dc.identifier.eissn.none.fl_str_mv 26665204
dc.identifier.journal.es_PE.fl_str_mv Resuscitation Plus
dc.identifier.eid.none.fl_str_mv 2-s2.0-105012038701
dc.identifier.scopusid.none.fl_str_mv SCOPUS_ID:105012038701
dc.identifier.pii.none.fl_str_mv S2666520425001547
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dc.identifier.ror.none.fl_str_mv 047xrr705
identifier_str_mv 10.1016/j.resplu.2025.101017
26665204
Resuscitation Plus
2-s2.0-105012038701
SCOPUS_ID:105012038701
S2666520425001547
0000 0001 2196 144X
047xrr705
url http://hdl.handle.net/10757/686704
dc.language.iso.es_PE.fl_str_mv eng
language eng
dc.rights.es_PE.fl_str_mv info:eu-repo/semantics/openAccess
dc.rights.*.fl_str_mv Attribution 4.0 International
dc.rights.uri.*.fl_str_mv http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
rights_invalid_str_mv Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
dc.format.es_PE.fl_str_mv application/pdf
dc.publisher.es_PE.fl_str_mv Elsevier B.V.
dc.source.es_PE.fl_str_mv Universidad Peruana de Ciencias Aplicadas (UPC)
Repositorio Academico - UPC
dc.source.none.fl_str_mv reponame:UPC-Institucional
instname:Universidad Peruana de Ciencias Aplicadas
instacron:UPC
instname_str Universidad Peruana de Ciencias Aplicadas
instacron_str UPC
institution UPC
reponame_str UPC-Institucional
collection UPC-Institucional
dc.source.journaltitle.none.fl_str_mv Resuscitation Plus
dc.source.volume.none.fl_str_mv 25
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JeannettMilling, LouiseBrøchner, Anne CraveiroLippert, FreddyBlomberg, Stig NikolajChristensen, Helle CollatzHolgate, RobynMorrison, Laurie J.Bakhsh, AbdullahMikkelsen, SørenAlsulimani, Loui K.Popela, StanislavVidunová, Jana KrubaPeran, DavidGregor, RomanPapousek, RenéSimić, AnđelaCairol, AndrésIngelmo, Vicente Sánchez BruneteBjörnsson, Hjalti MárStammet, PascalEscalante-Kanashiro, RaffoNikolaidou, OlympiaKarageorgos, VlasiosAslanidis, TheodorosWallner, BerndRief, MartinEichinger, MichaelChakra Rao, Siddha S.C.SinghMD, BaljitBirkun, Alexei A.Aguilera, PabloBakker, JanZaher, Muhammad SultanAlwajeeh, Sultan AliTanabe, SeizanIwami, TakuSaito, ShunsukeFraga-Sastrias, Juan ManuelKittivo, June EvaAchiro, Kephas OchiengNdinda, CarolineMonsieurs, KoenSnijders, ErwinAbdullah, NaseefStanton, DavidMeyer, John ThomasCrawford, Steven JohnLoghmari, DorraTurkia, Hela benBarbaria, WiemWijesuriya, NilminiDilruk Indika Rathnayake, Rathnayake MudiyanselageWoltman, NathanMesa-Gaerlan, Faith JoanConvocar, PaulineVelasco, Bernadett PuaAlihodžić, HajrizAlrawashdeh, AhmadAlwidyan, Mahmoud T.Soares-Oliveira, MiguelMota, MauroCao, YuYao, PengKin Lam, Rex PuiCheung, Arthur Chi KinBogár, BenceTemesvari, PeterGebei, RóbertKaraaslan, PelinSofuoglu, TurhanCiocan, LiviuJaeger, DéborahSung, Chih WeiChen, Chi HsinGellerfors, MikaelWahlin, Rebecka RubensonSchell, Carl OttoGardiner, FergusNichols, MartinPerillo, SamReid, DavidMohrsen, StianCorfield, Alasdair R.Allen, MarcFalcetta, StefanoMenarini, MaurizioRehn, MariusKramer-Johansen, JoBredmose, Per P.Olasveengen, Theresa MarieroUleberg, OddvarWilson, ThomasLindner, Thomas W.Jacobsen, LarsFormo, AmundElden, TrondOlsen, Mari StokstadKowalski, MarcinDerkowski, Tomasz2025-09-18T03:31:03Z2025-09-18T03:31:03Z2025-09-0110.1016/j.resplu.2025.101017http://hdl.handle.net/10757/68670426665204Resuscitation Plus2-s2.0-105012038701SCOPUS_ID:105012038701S26665204250015470000 0001 2196 144X047xrr705Background: Out-of-hospital cardiac arrest (OHCA) is a major public health problem. This study aims to describe the international variations in the practices related to the initiation, termination, and refraining from resuscitation of adult patients (≥18 years) with a non-traumatic OHCA. Methods: An exploratory descriptive study was conducted using a cross-sectional online survey. The respondents were recruited using snowball sampling technique. Framework analysis was used to identify key themes in responses, with descriptive statistics summarising data trends. Results: The study collected responses from 59 countries. Our findings reveal that respondents from 59.3% of countries reported that they initiate resuscitation in all cases where the patients do not show obvious signs of irreversible death or do not have confirmed advance directives. Respondents from 15.3% of countries reported that once started, prehospital resuscitation attempts are not terminated. Prehospitally respondents from 20.3% of the countries reported that they rely exclusively on specific criteria to decide when to terminate resuscitation efforts while in 45.8%, these decisions are made at the discretion of the provider. Respondents from most countries (91.5%) reported that they refrain from resuscitation in the presence of obvious signs of irreversible death. Respondents from 57.6% of countries, reported that they refrained from resuscitation if the patient had a confirmed do-not-attempt-cardiopulmonaryresuscitation (DNACPR), while 15.3% mentioned staff safety as a reason to abstain from attempting resuscitation. Conclusion: This study reveals global variation in EMS resuscitation practices, reflecting disparities in resources, healthcare infrastructure, EMS system design, community acceptability given cultural and societal norms, and legislation.Laerdal Foundation for Acute MedicineRevisión por paresapplication/pdfengElsevier B.V.info:eu-repo/semantics/openAccessAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/Universidad Peruana de Ciencias Aplicadas (UPC)Repositorio Academico - UPCResuscitation Plus25reponame:UPC-Institucionalinstname:Universidad Peruana de Ciencias Aplicadasinstacron:UPCEmergency care disparitiesHealth policiesHealth system capacityTermination of resuscitation (TOR)Prehospital cardiac arrest resuscitation practices differ around the globeinfo:eu-repo/semantics/article2025-09-18T03:31:04ZTHUMBNAIL1-s2.0-S2666520425001547-main.pdf.jpg1-s2.0-S2666520425001547-main.pdf.jpgGenerated Thumbnailimage/jpeg119115https://repositorioacademico.upc.edu.pe/bitstream/10757/686704/5/1-s2.0-S2666520425001547-main.pdf.jpgcfd6a5d0e940d1d842dd456937a973faMD55falseTEXT1-s2.0-S2666520425001547-main.pdf.txt1-s2.0-S2666520425001547-main.pdf.txtExtracted texttext/plain34599https://repositorioacademico.upc.edu.pe/bitstream/10757/686704/4/1-s2.0-S2666520425001547-main.pdf.txt42f63bff0b5bf97b777495a2d76ace71MD54falseLICENSElicense.txtlicense.txttext/plain; charset=utf-81748https://repositorioacademico.upc.edu.pe/bitstream/10757/686704/3/license.txt8a4605be74aa9ea9d79846c1fba20a33MD53falseCC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8908https://repositorioacademico.upc.edu.pe/bitstream/10757/686704/2/license_rdf0175ea4a2d4caec4bbcc37e300941108MD52falseORIGINAL1-s2.0-S2666520425001547-main.pdf1-s2.0-S2666520425001547-main.pdfapplication/pdf495411https://repositorioacademico.upc.edu.pe/bitstream/10757/686704/1/1-s2.0-S2666520425001547-main.pdfb140a17d9eca81aae0999bef02acb851MD51true10757/686704oai:repositorioacademico.upc.edu.pe:10757/6867042025-09-26 02:18:31.209Repositorio académico upcupc@openrepository.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