Enhancing Cardiac Arrest Management in Prehospital Settings in Saudi Arabia

Abstract

Aim: This study aimed to evaluate the current challenges and practices in managing out-of-hospital cardiac arrest (OHCA) in Saudi Arabia, with a focus on improving bystander intervention through cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use. The research sought to assess public knowledge, attitudes, and barriers to CPR and AED utilization to provide evidence based recommendations for strengthening prehospital cardiac arrest response.

Methods: A Quantitative approach was employed, combining a comprehensive literature review with a cross-sectional survey. The literature review analyzed peer-reviewed studies, national reports, and international guidelines on OHCA management in Saudi Arabia and comparable contexts. The survey, conducted online, included 229 Saudi residents aged 18 years or older, assessing demographics, CPR knowledge, AED awareness, willingness to act, and perceived barriers. Data were analyzed descriptively, and logistic regression identified factors influencing bystander willingness to perform CPR.

Results: The survey revealed that while 70% of respondents expressed willingness to perform CPR, only 33% were very familiar with CPR steps, and 48% recognized AEDs. Key barriers included fear of causing harm (54%), legal concerns (31%), and reluctance to perform mouth-to-mouth ventilation (12%). Prior CPR training and exposure to awareness campaigns significantly increased willingness to act (OR = 2.4, *p* = 0.05). Urban-rural disparities were noted, with rural areas exhibiting lower awareness of CPR campaigns (20% vs. 33% in urban centers). Qualitative feedback emphasized the need for practical training, increased AED availability, and legal reassurance to encourage bystander action.

Conclusion: The study highlights critical gaps in public preparedness for OHCA response in Saudi Arabia, including insufficient CPR knowledge, low AED awareness, and persistent cultural and legal barriers. To address these challenges, the study recommends integrating CPR training into school curricula, expanding AED deployment in public spaces, launching nationwide awareness campaigns, and implementing dispatcher-assisted CPR protocols. Strengthening community engagement and leveraging technology, such as volunteer responder apps, could further enhance the "Chain of Survival" and improve OHCA outcomes. These measures align with global best practices and offer a roadmap for reducing preventable deaths from cardiac arrest in Saudi Arabia.