Cardiopulmonary resuscitation performed by trained providers and shorter time to emergency medical team arrival increased patients' survival rates in Istra County, Croatia: a retrospective study

Aim To assess the effect of the time for emergency medical services (EMS) arrival on resuscitation outcome in the transition period of the EMS system in Istra County. Methods This retrospective study analyzed the data from 1440 patients resuscitated between 2011 and 2017. The effect of demographic data, period of the year, time for EMS arrival, initial cardiopulmonary resuscitation (CPR) provider, initial cardiac rhythm, and airway management method on CPR outcome was assessed with multivariate logistic regression. Results Survivors were younger than non-survivors (median of 66 vs 70 years, P < 0.001) and had shorter time for EMS arrival (median of 6 vs 8 min, P < 0.001). The proportion of non-survivors was significantly higher when initial basic life support (BLS) was performed by bystanders without training (83.8%) or when no CPR was performed before EMS team arrival (87.3%) than when BLS was performed by medical professionals (66.8%) (P < 0.001). Sex, airway management, and tourist season had no effect on CPR outcome. Conclusion Since the time for arrival and level of CPR provider training showed a significant effect on CPR outcome, further organizational effort should be made to reduce the time for EMS arrival and increase the number of individuals trained in BLS.