{
  "abstract": "Introduction Out-of-Hospital Cardiac Arrest (OHCA) represents a major cause of mortality in Ireland. With low survival rates and the time-sensitive nature of cardiac arrest, early intervention is paramount in optimizing patient outcomes. As such, early community-based response, through bystander CPR and automated external defibrillation (AED), remains a fundamental component in Ireland’s chain of survival. However, significant gaps exist in recent research examining the relationship between community-based interventions and patient survival in the Irish healthcare context.Objective To examine trends in bystander intervention and early defibrillation for non-EMS-witnessed OHCA incidents in Ireland (2021–2023) and assess associations with patient survival to hospital discharge.Methods Retrospective analysis was conducted on 7,515 non-EMS-witnessed OHCA incidents from 2021–2023, stratified by bystander intervention (CPR and defibrillation) and survivorship outcomes. Associations between bystander intervention and survival, in addition to crude survival rates between pre-EMS and EMS defibrillation were statistically examined using Cochran-Armitage Trend Test and Chi-Square Test.Results OHCA survivors receiving bystander CPR demonstrated a significant upward trend (z = 2.77, p = 0.0057). Attempted pre-EMS defibrillation rates increased significantly from 2021–2023 (Z = 5.40, p < 0.00001), and the percentage of survivors receiving bystander defibrillation showed an overall linear increase with significant year-to-year variation (χ² (n=464) = 7.55, p = 0.023). Patients receiving pre-EMS defibrillation had superior crude survival rates compared to EMS defibrillation from 2021–2023 (e.g., 28.95% vs 15.18% in 2023; χ²=23.32, p<0.001).Abstract #141 Figure 1Conclusion This analysis demonstrates meaningful improvements in Ireland’s community-based OHCA response from 2021–2023 with increasing rates of early defibrillation and significant associations with survival. However, despite these improvements and association with survival, a majority of OHCA patients still do not receive pre-EMS defibrillation. Ultimately, a coordinated national response is necessary to expand public AED programs and increase AED accessibility, thereby empowering communities and improving future cardiac arrest outcomes in Ireland.Crude survival rates (%) to hospital discharge among non-EMS-witnessed OHCA patients in Ireland (2021–2023), stratified by defibrillation performed prior to EMS arrival (pre-EMS) versus EMS personnel. Across all three years, survival rates were higher for patients receiving pre-EMS defibrillation compared with EMS defibrillation. (2021: χ²=5.32, p=0.021; 2022: χ²=54.91, p<0.001; 2023: χ²=23.32, p<0.001). *presenting author",
  "authors": [
    {
      "affiliations": [
        "School of Medicine, University of Limerick, Ireland"
      ],
      "name": "Connor Pires"
    },
    {
      "affiliations": [
        "School of Medicine, University of Limerick, Ireland",
        "ALERT, Emergency Department, University Hospital Limerick, Ireland"
      ],
      "name": "Alan Watts"
    }
  ],
  "title": "#141 Early intervention matters: a national retrospective analysis of pre-EMS defibrillation and community response in out-of-hospital cardiac arrest in Ireland from 2021–2023",
  "uid": "2c9c91d1-27c4-5a93-9930-3213ee3f340b"
}