Enhancing community awareness and survival rates through a systemic approach to cardiac arrest
Article information
Dear Editor,
Out-of-hospital cardiac arrest (OHCA) survival relies heavily on rapid intervention, which is achievable through a systemic approach including community resources and emergency medical services (EMS) [1]. The interplay of bystander action, technological integration, and post-resuscitation care exemplifies how this strategic integration may transform outcomes. Sharing positive experiences within the community after post-arrest care can reinforce the importance of bystander cardiopulmonary resuscitation (CPR), enhancing collaboration between EMS and the public.
This commentary focuses on a 76-year-old male patient who experienced an OHCA while at a community center in Bologna, Italy, and how his experience might improve awareness through effective communication. Here, we analyze three critical aspects of this case: the role of community engagement, the impact of effective communication in increasing public knowledge on cardiac arrest response, and the integration of technology in improving survival rates.
Community involvement was essential in this case, demonstrating the importance of training laypersons in CPR and automated external defibrillator (AED) usage to survival of an OHCA patient. The bystander’s swift action in initiating CPR and applying the AED led to the first shock being delivered within 3 minutes 24 seconds, successfully restoring cardiac rhythm (Fig. 1). This underscores the necessity of widespread community education and the establishment of public access defibrillation (PAD) networks in high-risk areas [2]. Programs that standardize CPR and AED training can significantly enhance layperson confidence and capability, ensuring rapid intervention during emergencies. In addition, EMS dispatchers may provide first-aid instructions and support bystanders in overcoming barriers and uncertainties until the arrival of rescue teams on the scene [3].
Key components of a systemic approach for cardiac arrest response. CPR, cardiopulmonary resuscitation; AED, automated external defibrillator; EMS, emergency medical services.
Following hospital discharge, the patient and his family actively participated in awareness campaigns, becoming advocates for cardiac arrest preparedness in their local community. Disseminating such success stories creates a virtuous cycle, starting from the community and returning to the community, inspires others, and strengthens motivation and support for resuscitation programs. The information about this successful experience reached a massive audience in a couple of weeks, with the web content shared by the healthcare agency and local newspapers and televisions reaching 0.9 million users (Table 1 and Supplementary Material 1). As part of community education, sharing survivor stories through local campaigns can inspire others, strengthening public motivation and influencing policy toward a better culture of preparedness for resuscitation.
Web and social media interactions
Integrating dispatcher-assisted CPR and the first responder app network demonstrates how technology can streamline emergency response [4]. In this case, dispatcher guidance helped the bystander act decisively, while the first responder app ensured the rapid arrival of an off-duty healthcare professional within three minutes. An ambulance arrived on the scene in 4 minutes, and the advanced life support team arrived in 15 minutes, by which time the patient had already achieved return of spontaneous circulation. Combined within a systematized EMS framework, these elements exemplify how technology can reduce response times and increase survival.
The role of technology extends to data-driven system optimization. For instance, AED placement strategies informed by case analysis can further enhance PAD networks. Research into smartphone-based first responder activations highlights the value of minimizing delays and maximizing early intervention [5].
This case reinforces the need for a multifaceted approach to cardiac arrest management. Community training, PAD accessibility, and technological integration should be key pillars of public health strategies [6]. Policymakers must prioritize funding for standardized CPR education and PAD network expansion. Additionally, integrating survivor testimonials and patient stories into educational tools fosters a culture of preparedness, empowering communities to contribute to the chain of survival. Survivor advocacy should be formalized within public-oriented initiatives, paving the way to an amplified societal impact of resuscitation successes and promoting specific research projects aimed at optimizing outcomes [7].
Future research should focus on community-driven awareness campaigns and standardizing education protocols. Moreover, integrating patient narratives into training programs could humanize the importance of preparedness, potentially increasing layperson participation in resuscitation efforts. Such measures would align with health policy objectives aimed at sustaining robust resuscitation systems globally [8].
In conclusion, the synergy of community engagement, systemic organization, and technological innovation exemplifies how coordinated efforts can dramatically improve cardiac arrest outcomes. This case illustrates that empowering communities and leveraging technology are indispensable to advancing resuscitation science and saving lives.
Notes
Ethics statement
Informed consent was obtained from the patient and his family.
Author contributions
Conceptualization: all authors; Data curation: all authors; Formal analysis: all authors; Writing–original draft: all authors; Writing–review & editing: all authors. All authors read and approved the final manuscript.
Conflicts of interest
Guglielmo Imbriaco is a member of the Scientific Committee of the Italian Resuscitation Council and is on the Board of Aniarti, the Italian Association of Critical Care Nurses. Federico Semeraro is the chair of the European Resuscitation Council and an emeritus member of the International Advisory Committee on Resuscitation (ILCOR) Basic Life Support (BLS) Working Group. Lorenzo Gamberini is a member of the Scientific Committee of the Italian Resuscitation Council. One of the authors was involved as a first responder activated by the DAE RespondER app (Regione Emilia-Romagna) during the patient’s rescue. However, this was not reported to the press to avoid influencing the perceived importance of the bystander’s role compared to the intervention of a healthcare professional. The authors have no other conflicts of interest to declare.
Funding
The authors received no financial support for this study.
Data availability
Data analyzed in this study were extracted from a clinical trial registered on ClinicalTrials.gov (identifier: NCT04510480), which was approved by the local ethics committee. The dataset is available from the corresponding author upon reasonable request.
SUPPLEMENTARY MATERIAL
Supplementary materials are available from https://doi.org/10.15441/ceem.25.014.
Supplementary Material 1.
Web content shared by the healthcare agency and local newspapers and television (translation and summaries provided by the authors).