Bystander Response

Community Initiatives to Improve Survival

Survival from out-of-hospital cardiac arrest is directly linked to the system of care that exists in the community.

When the following events occur, the victim has the best possible chance for survival:

  • A bystander recognizes what happened and activates the emergency response by calling 911 and getting an AED if one is available.
  • CPR with an emphasis on chest compressions is initiated immediately.
  • An AED is rapidly applied and a shock delivered if indicated.
  • EMS professionals respond quickly and perform effective resuscitation techniques.
  • The receiving hospital provides state-of-the-art integrated post-cardiac arrest care.

Failure to provide any of these critical interventions will significantly decrease survival. To maximize survival, each of the steps described above must be comprehensively evaluated, tested, and improved.

EMS-treated bystander witnessed ventricular fibrillation is the standard SCA survival statistic used in this document unless otherwise noted. These victims have the best chance of survival and serve as a sentinel measure for the system of care.

Communities exhibit a wide variation in survival rates, from 0% to 48% (median 18%) for EMS-treated bystander witnessed ventricular fibrillation arrest.1,2,3 The variation between communities is reduced through efforts to increase bystander CPR, ensure AED usage, and provide the highest quality EMS care. A cardiac arrest victim is twice as likely to live when bystanders give CPR, and survival can again be doubled when AEDs are used.4,5

Members of the general public can help improve survival from cardiac arrest in several ways. They can learn CPR or purchase an AED for their school, church, or business. They can ask their elected representatives how effectively their community's system of care for victims of cardiac arrest is functioning. Finally the public must demand change when the system is failing those victims.

Next: Bystander Action