Is poor, with little progress being made

Papers p 515)

Despite enormous efforts to improve survival during the past three decades, cardiac arrest outside hospital still makes a disproportionately large contribution to mortality in the Western world. 1 2 So far, the only really valuable interventions have been cardiopulmonary resuscitation, often provided by a bystander, and rapid defibrillation, which is useful if the patient presents with ventricular fibrillation or ventricular tachycardia when emergency medical services arrive. The deployment of automated external defibrillators in selected sites, to be used by (trained) laypersons, has been described as a way to achieve faster defibrillation and improved survival after cardiac arrest outside hospital. 3 Such plans may, however, result in limited success, given the current epidemiological developments.

In this issue (p 515) Pell and colleagues present a detailed breakdown of locations in Scotland where patients had cardiac arrests outside hospital over seven years and try to predict the …