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

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.