The Critical Role Of Paramedics In Cardiac Emergencies: Evidence-Based Protocols For Adults And Children

Abstract

Cardiac emergencies, including sudden cardiac arrest and life-threatening arrhythmias, remain a leading cause of morbidity and mortality worldwide. Rapid, evidence-based interventions delivered by paramedics are critical to improving survival and neurological outcomes in both adults and children. This review examines the pivotal role of paramedics in adhering to and applying current cardiac emergency protocols, focusing on differences and similarities between adult Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) guidelines. Evidence from recent studies demonstrates that high-quality cardiopulmonary resuscitation (CPR), timely defibrillation, effective airway management, and appropriate pharmacologic interventions significantly increase return of spontaneous circulation and long-term survival. Pediatric cardiac emergencies present unique challenges due to anatomical, physiological, and emotional factors, often requiring specialized skills such as intraosseous access and adjusted resuscitation ratios. The review highlights variations in paramedics’ protocol adherence across different healthcare systems, logistical barriers such as equipment availability, and ethical issues including resuscitation termination and parental involvement. By synthesizing current evidence, this article underscores the critical contribution of paramedics in the chain of survival and calls for enhanced training, pediatric-focused simulation, and integration of emerging technologies such as telemedicine and mechanical CPR devices. Strengthening paramedic practice remains essential for optimizing outcomes across all age groups.