The Albany Gazette - Fewer Than 40% of Cardiac Arrest Patients Transferred to Hospital in National Review

Approximately 38 percent of patients who received out-of-hospital resuscitation for cardiac arrest last year were transported to a hospital, according to new data released by the National Ambulance Service (NAS). The figures reveal stark regional disparities in emergency care outcomes, with the Mid-West recording the lowest rates of hospital transfer and survival.

The NAS recorded 2,756 incidences of cardiac arrests attended by emergency personnel last year where resuscitation was initiated or continued. Of these cases, only 1,058 patients were transported by ambulance to a hospital facility.

Regional analysis indicates that the Mid-West had the lowest proportion of hospital transfers among this group. Of the 233 out-of-hospital cardiac arrest cases recorded in the region where resuscitation was attempted or continued, just 68 patients, or 29 percent, were transported to a hospital.

The Mid-West also reported the lowest rate of return of spontaneous circulation (ROSC), defined as the moment a patient’s heart resumes a sustained, independent rhythm after cardiac arrest. The ROSC rate in the region stood at 21 percent, compared to a national average of 25 percent. Furthermore, the proportion of patients achieving ROSC upon arrival at the hospital was the lowest nationally at 17 percent, against a national average of 20 percent.

Survival outcomes mirrored these trends. The percentage of patients surviving to hospital discharge in the Mid-West was 7.3 percent, compared with 9.7 percent nationally. The region also recorded a median ambulance call-to-scene response time of 17 minutes, which is two minutes longer than the national median of 15 minutes.

In contrast, Dublin and the North-East, identified as the Health Service Executive (HSE) region with the highest number of out-of-hospital cardiac arrests, recorded higher transfer rates. Of the 590 incidents recorded in this region last year, 50 percent were transported to a hospital. The region’s median ambulance response time was 12 minutes, and 12.9 percent of patients survived to hospital discharge.

While urban areas with higher hospital transfer rates recorded a higher proportion of patients discharged alive, the NAS cautioned against assuming a direct causal link between transport volume and survival. The service stated there was no evidence that a higher proportion of patients being transported was associated with higher survival rates.

The NAS also advised that regional differences in survival outcomes should be interpreted carefully due to the relatively small number of cases involved. The service added that there was no statistically significant difference in survival to hospital discharge between the six HSE regions.

The figures were provided to Fine Gael TD Joe Cooney, who stated they raise important questions regarding emergency response capacity and ambulance provision across Clare, Limerick, and North Tipperary.

“When somebody suffers a cardiac arrest, every minute matters. The speed of the emergency response and the availability of appropriate resources can be critical,” Cooney said. “While the National Ambulance Service has advised that there is no statistically significant difference in survival rates between the regions, the combination of these figures raises legitimate questions about how emergency services are operating across the Mid-West.”

Cooney emphasized the need to understand whether specific challenges arising from the region’s geography, rural communities, ambulance deployment, or access to emergency hospital services contribute to the data. He indicated he would seek further clarification from the HSE and the NAS on the factors contributing to these figures.

“This is about ensuring that people in Clare, Limerick and North Tipperary receive the same standard of emergency care and have the best possible chance of survival when faced with a life-threatening medical emergency,” he said.

(D.Sanchez--TAG)