Background Out-of-Hospital Cardiac Arrest (OCHA) remains a significant challenge for healthcare systems, with actions by witnesses playing a critical role. This study examines Polish data from the European Registry of Cardiac Arrest (EuReCa), identifying progress in updated paramedic protocols and public availability of automated external defibrillators (AED) while noting issues such as delays in emergency call localization, lack of synchronization in defibrillator maps, inadequate reporting, and absence of information on long-term neurological outcomes.

Aims The aim of this study was to assess the role of bystanders and dispatchers in the chain of survival for OHCA.

Methods A retrospective analysis was conducted on 8,253 patients included in the EuReCa between 2014 and 2022. Data were collected from emergency medical team reports, and survival outcomes at 30 days were obtained from the national death registry.

Results Full cardiopulmonary resuscitation (CPR) performed by witnesses, including both chest compressions and rescue breaths, combined with the use of AED, significantly increased the likelihood of return of spontaneous circulation (ROSC) compared to chest compressions alone or no intervention. Dispatcher-guided resuscitation increased ROSC from 22.1% to 30.6% (p=0.01), though the increase in 30-day survival from 42.8% to 48.2% was not statistically significant (p=0.27). CPR by witnesses increased the number of patients transported to hospital with ROSC(74.0% vs. 26.0%; p=0.01).

Conclusions Bystanders and dispatchers are pivotal in the chain of survival. Improving the quality of reporting on actions taken by witnesses, including dispatcher-assisted resuscitation and the use of automated defibrillators, is critical for identifying effective strategies and allocating resources to improve survival and outcomes for cardiac arrest outside hospitals in Poland.

The authors have declared no competing interest.

The study was funded from internal research funds allocated under the announcement of the Deputy Rector Representative for Science and International Cooperation of the Jagiellonian University Medical College for projects financed from the Ministry of Education and Science MEiN subsidy

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dawidwilczek97gmail.com

grzegorz.cebulauj.edu.pl

daria.orzechowskastudent.uj.edu.pl

tomasz.tokarekuj.edu.pl

Conflict of Interest Statement The authors declare that they have no conflicts of interest to disclose related to this study. No financial, personal, or professional relationships influenced the research, analysis, or reporting of the findings presented in this manuscript.

This declaration ensures the integrity and transparency of the study.

All data produced in the present study are available upon reasonable request to the authors