Emergency response management and outcomes of out-of-hospital sudden cardiac arrest patients at exercise and sport facilities in Queensland, Australia

Aim: In the event of an out-of-hospital sudden cardiac arrest (OHSCA), timely cardiopulmonary resuscitation (CPR) and utilisation of an automated external defibrillator (AED) are crucial to increase the chances of survival. This study aims to analyse the emergency response management and outcomes of OHSCA patients at exercise and sport facilities (ESF) in Queensland, Australia. Methods: The de-identified electronic OHSCA data was obtained from the Queensland Ambulance Services (QAS) for the eight year period between 2007 and 2015. The data was systematically extracted, coded and categorised before statistical analysis. Results: There were 250 OHSCA cases at ESF after exclusions (e.g. vehicle trauma, home, <18 years old) key word search by type of sports. Potential cases were manually reviewed by street address for relevance. The OHSCA patients had a mean age of 59.39 (±15.169) and were mostly male (n=187, 86.6%). Following paramedic’s arrival and treatment, 38.8% (n=97) of the OHSCA patients improved, while 32.4% (n= 81) died mostly on the scene (25.2%, n=63). On-arrival, 75.6% (n=189) of the OHSCA patients were being applied CPR by the bystanders that was associated with 6.8% more improvement of the patients compared to no CPR by the bystanders. However, effective CPR (38%, n=95) was associated with 13.6% more improvement of the patients than non-effective CPR (62%, n=155) by the bystanders. Only at 12.4% (n=31) of the ESF both CPR and AED were applied by the bystanders that was associated with 4% less deaths than CPR only. Conclusions: These findings show that emergency management of cardiac events at ESF in Queensland are suboptimal. This study has implications for ESF operators to revise their risk management programs including medical emergency plans and procedures, and ensure they have staff currently trained in CPR and use of an AED to be capable of properly responding to an unexpected SCA event.