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Cardiac arrest
Big community arrest programme didn't change survival
Community and EMS Interventions to Improve Survival in Cardiac Arrest
The New England Journal of Medicine · 2026-11-08 · Added 10 November 2026
A cluster-randomised trial across 55 North Carolina county clusters (22,459 patients with out-of-hospital cardiac arrest) found a multifaceted community and EMS programme did not improve survival with good neurological outcome (9.0% vs 9.4%).
- Study type
- RCT
- Design
- Registry-based cluster-randomised trial (CARES registry, North Carolina)
- Participants
- 22,459 adults with OHCA across 55 county clusters
- Main finding
- Survival to discharge with good neurological outcome 9.0% (intervention) vs 9.4% (usual care), adjusted OR 0.97, 95% CI 0.75–1.26, P = 0.80
- Caveat
- The intervention bundled four components, so it can't show whether one element — such as telecommunicator CPR instructions — underperformed
- Bottom line
- Supports current practice
Why it matters in Australia (High relevance). Dispatch recognition, telephone CPR instructions, community CPR training and first-responder AED use are core parts of Australian systems, and this is a large cluster-randomised trial with a clear null result.
Learning goal
Weigh how bundled community and EMS resuscitation interventions influence survival outcomes in out-of-hospital cardiac arrest.
More
- Topic: Cardiac arrest
- Daily scan: 10 November 2026
- Podcast: Paramedic Papers Daily, 10 November 2026
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