With mortality rates above 90 percent, out-of-hospital cardiac arrest (OHCA) is among the most devastating medical emergencies. National organizations, state governments and local communities have attempted to battle such events by supporting public awareness and improving preparedness, most notably through CPR training and use of automated external defibrillators (AEDs).

A recent study—published online July 31 in Resuscitation, the journal of the European Resuscitation Council—examined the effectiveness of the Minnesota Heart Safe Communities program.

The researchers examined 294 OHCAs treated by Allina Health Emergency Medical Services in 17 Heart Safe (HS) communities—120 occurring before HS designation and 174 occurring after.

Bystanders or first responders delivered CPR before arrival of an ambulance in 85 percent of cases before HS and 95 percent afterward. AED use increased from 63 percent prior to HS designation to 77 percent after.

“It appears that much of the gain from HS may be occurring in first responders rather than laypersons, which may reflect more rapid recognition of OHCA as a result of additional training as well as increased access to AEDs in first responder vehicles,” wrote Lori Boland, principal research scientist for Allina Health EMS and lead author of the study, and colleagues.

While the majority of OHCA victims do not receive CPR, the researchers pointed out a need for implementation science to improve programs to boost care before ambulance arrival.

"The American Heart Association provides clear guidelines on how to optimize survival after cardiac arrest, and our results show the Heart Safe program has been effective in helping communities translate those guidelines into practice," Boland said.