Strategies for Equity in Community Response to Out-of-Hospital Cardiac Arrest

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In NZ, areas of socioeconomic deprivation have higher rates of out-of-hospital cardiac arrest. Incidence is also increased in areas with increased populations of Māori, Pacific Peoples and those over 65 years old. Recent publications indicate that there is less availability of public access defibrillators in areas of increased deprivation. Emergency medical services are investigating strategies to target these inequities. To improve rates of bystander cardiopulmonary resuscitation (CPR) and community defibrillation there are several strategies employed by St John and/or Wellington Free Ambulance. Community awareness programmes, 3 Steps for Life and Heartbeat are delivered free of charge to communities to learn CPR and how to use an automated external defibrillator (AED). Targeted training to schools, such as ASB St John in Schools, delivers training to students irrespective of socioeconomic status. Both ambulance services also support compulsory first aid training as part of the school curriculum. Annual World Restart-a-Heart Day on the 16th of October is a public awareness day to promote calling the emergency phone number, starting CPR and using an AED. The national Marae OHCA project is a partnership between Māori and St John, to improve access to AEDs and support training in CPR. Nationally, the GoodSAM smartphone application alerts members of the public who are trained in CPR to respond via their smartphones to nearby cardiac arrests and provide immediate assistance. The most socioeconomically deprived communities have the highest incidence of OHCA. NZ ambulance services are providing a range of community programs and services which specifically target these inequities.