Out-of-Hospital Cardiac Arrest: A Strategy for Scotland

The Out-of-Hospital Cardiac Arrest(OHCA) strategy, which has been developed in collaboration with a range of stakeholders, is a 5 year plan with the aim of ensuring that by 2020 Scotland becomes an international leader in OHCA outcomes. The headline aim is to save an additional 1,000 lives by 2020.


Annex B: Contribution of the Scottish Ambulance Service

The Scottish Ambulance Service (SAS) is central to the delivery of high quality pre-hospital care and to improving OHCA performance and outcomes. SAS has an important contribution to make across the whole Augmented Chain of Survival as a provider, co-ordinator, collaborator and enabler. The contribution of SAS runs throughout this strategy document. This annex draws together these contributions into a single list.

Readiness

  • Support and enable partners and communities to ensure an effective 'assets based' approach to the response to OHCA.
  • Provide a highly-trained workforce, enabled to respond to OHCA whether in ACCs or in Communities, utilising training, audit and feedback.
  • Ensure co-responders (including CFRs, SFRS, BASICS) and Public Accessible Defibrillators are mapped onto ACC systems.
  • Ensure appropriate information regarding prior end-of-life care decisions is made available to ambulance crew via integrated clinical IT systems.
  • Further roll out 3RU in urban communities.
  • Design and deliver integrated response models with SFRS and other partners.
  • Work with a variety of remote/rural partners to design and deliver bespoke solutions for effective OHCA response to remote and rural communities.
  • Create a climate of positivity around this crucial area of emergency response.

Early Recognition of Cardiac Arrest

  • Optimise systems and training in ACCs to ensure rapid recognition of cardiac arrest.
  • Rapid dispatch of resources appropriate to the location.
  • Provide expert support to bystanders including T-CPR guidance to bystanders providing CPR.

Early CPR

  • Ensure SAS response times are as rapid as possible and that the correct resource configuration is deployed.
  • Work in partnership with others (such as BHF, SFRS) to maximise delivery of appropriate CPR training to individuals and communities.
  • Maintain and extend the CFR network.
  • Ensure that the crews first on scene provide CPR of the highest quality.

Early Defibrillation

  • Ensure PADS are mapped onto the ACC system to increase their accessibility and availability to bystanders and so enable their rapid utilisation.
  • Ensure that the crews first on scene provide rapid defibrillation where appropriate.

Post Resuscitation Care

  • Further develop Advanced Life Support capacity through training and the implementation of best-evidenced care delivery.
  • Implement technology-led improvements where appropriate.
  • Develop and implement in collaboration with clinicians and NHS Boards the most effective patient pathways based on patient need.

Rehabilitation and Aftercare

  • Enable support to SAS staff, co-responders and bystanders who are affected by involvement in OHCA.
  • Collect and provide data into systems to ensure that patients/families can access appropriate aftercare.

Registry and Research

  • Ensure that SAS data is robust and complete in order to optimise the understanding of outcomes.
  • Report and regularly review a range of key measures of OHCA performance.
  • Contribute to the development of an effective OHCA Registry.
  • Respond to evidence by making system improvements and evaluating effectiveness.
  • Generate and help to answer research questions to provide evidence to shape practice both in Scotland and internationally.

Contact

Email: David Cline

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