The Impact Of Paramedic-Performed Cardiopulmonary Resuscitation On Survival Outcomes In Emergency Situations: A Systematic Review

Abstract

Out-of-hospital cardiac arrest (OHCA) remains a critical global health emergency with high mortality rates, where the timely initiation of cardiopulmonary resuscitation (CPR) plays a decisive role in patient outcomes. Paramedics are often the first advanced healthcare providers to respond to such emergencies, and their performance of CPR significantly influences survival rates, neurological recovery, and hospital discharge outcomes. This systematic review investigates the impact of paramedic-performed CPR on survival outcomes in emergency situations, examining clinical effectiveness, response time, skill proficiency, and the integration of technological advancements such as mechanical CPR devices and automated external defibrillators (AEDs). Relevant studies published between 2016 and 2025 were retrieved from PubMed, Scopus, and Web of Science using defined inclusion criteria. The findings demonstrate that paramedic-delivered CPR is associated with improved return of spontaneous circulation (ROSC), increased survival to hospital admission, and better neurological outcomes when compared with CPR initiated by laypersons alone. Moreover, early intervention, continuous high-quality compressions, and team-based coordination significantly enhance the chain of survival. However, variability in outcomes is noted due to differences in EMS system infrastructures, training protocols, and geographic response times. This review emphasizes the critical role of paramedics in reducing pre-hospital mortality and supports strategic advancements in EMS training, technology integration, and policy development to optimize patient outcomes.