The fact that we have, in the USA, a wide variability in SCA survival tells us that "better is possible." Phoenix recently improved from 26% to 56%. Kings County, Washington (Seattle) has enjoyed 50% + /- for twenty years. Hilton Head, SC has jumped from 10% to 66% in two years.
Yes, the resuscitation has to be achieved in the field, but there are subsequent actions that require hospital participation. For example (a) therapeutic hypothermia,and (b) hearth cath for SCAs caused by coronary artery blockage - frequently the LDA.
The change that needs to be made is not one of treating and calling in the field, but one of treating differently in the field and then either calling or transporting. There is so much more that we can do that is not being done.
Competing interests: No competing interests