Rural and remote cardiac outcomes: examination of a state-wide emergency medical service

Abstract:

The Chain of Survival describes the factors most critical to survival from out-of-hospital cardiac arrest (OHCA). Outcomes from OHCA outside of urban areas are infrequently reported, perhaps due to the challenge of applying the chain of survival to these settings. Greater distances may prolong paramedic response times, delaying CPR and defibrillation for many patients. Additionally, extra-urban areas may be served by less sophisticated EMS services, with services in many cases provided by volunteer responders and so may feature less access to advanced life support (ALS) interventions. While the above factors may affect survival rates outside of urban areas, few studies exist which compare survival from OHCA in urban and rural areas. Furthermore, these studies assume homogeneity among the rural sample. This assumption may be flawed as many rural areas feature a mix of relatively populous rural centres and extremely remote communities. The current study aims to compare survival from OHCA between city, regional and remote areas in the state of Queensland in order to better describe the effect of remoteness on survival. We will report on differences in patient, scene and EMS variables between location types, and how these influence survival.