Challenges and Opportunities of Artificial Intelligence Implementation in the Management of Out-of-Hospital Cardiac Arrest: Scoping Review

https://doi.org/10.56303/jhnresearch.v4i2.429

Authors

  • Heriyansyah Dalle Postgraduate Program of Nursing, Universitas Padjadjaran, Bandung, Indonesia
  • Yanny Trisyani Department of Emergency and Critical Care Nursing, Universitas Padjadjaran, Bandung, Indonesia
  • Aan Nuraeni Department of Emergency and Critical Care Nursing, Universitas Padjadjaran, Bandung, Indonesia

Keywords:

Stress Levels, Reading the Holy Al-Quran, Hypertension

Abstract

Out-of-hospital cardiac arrest (OHCA) remains a major global health challenge with low survival rates. Artificial intelligence (AI) has emerged as a promising tool to enhance early detection, response, and management of OHCA cases. This study explores the current use of AI in OHCA, identifying challenges and opportunities related to its implementation. This scoping review followed the PRISMA-ScR guidelines, utilizing a systematic search of international databases to identify relevant literature. A total of 10 studies were included, comprising cohort studies, observational studies, randomized controlled trials (RCTs), and pilot projects from 10 different countries. AI implementation in OHCA management demonstrated several opportunities, including improved early detection (increasing sensitivity by 5.5–15% and reducing EMS response time by up to 26 seconds), enhanced decision support for termination of resuscitation (with specificity up to 99.0%), and increased bystander engagement through real-time CPR guidance. However, challenges remain, such as data privacy, ethical concerns (especially with visual surveillance and GDPR compliance), infrastructure limitations, and variability in local protocol. The paradox between faster detection and improved CPR quality was also noted. AI has significant potential to improve OHCA outcomes by optimizing detection, response, and clinical decision-making. Successful implementation requires multidisciplinary collaboration, robust external validation, and ethical considerations to address privacy and local adaptation. Integrating AI into emergency systems and public training can enhance survival rates, but further large-scale studies are needed to ensure effectiveness and equity.

Downloads

Download data is not yet available.

References

Kashiura M, Hamabe Y, Akashi A, Sakurai A, Tahara Y, Yonemoto N, et al. Applying the termination of resuscitation rules to out-of-hospital cardiac arrests of both cardiac and non-cardiac etiologies: a prospective cohort study. Crit Care. 2016 Mar 1;20(1):49.

Hsu SH, Sun JT, Huang EPC, Nishiuchi T, Song KJ, Leong B, et al. The predictive performance of current termination-of-resuscitation rules in patients following out-of-hospital cardiac arrest in Asian countries: A cross-sectional multicentre study. PLoS One. 2022 Aug 10;17(8):e0270986.

Böttiger BW, Becker LB, Kern KB, Lippert F, Lockey A, Ristagno G, et al. BIG FIVE strategies for survival following out-of-hospital cardiac arrest. Eur J Anaesthesiol. 2020 Nov;37(11):955–8.

Mary M. Newman. AHA. 2022 [cited 2025 May 8]. AHA releases Heart and Stroke Statistics – 2022 Update. Available from: https://www.sca-aware.org/sca-news/aha-releases-heart-and-stroke-statistics-2022-update

Okubo M, Chan HK, Callaway CW, Mann NC, Wang HE. Characteristics of paediatric out-of-hospital cardiac arrest in the United States. Resuscitation [Internet]. 2020 Aug 1;153:227–33. Available from: https://doi.org/10.1016/j.resuscitation.2020.04.023

Rzońca P, Gałązkowski R, Panczyk M, Gotlib J. Polish Helicopter Emergency Medical Service (HEMS) Response to Out-of-Hospital Cardiac Arrest (OHCA): A Retrospective Study. Medical Science Monitor. 2018 Aug 31;24:6053–8.

AHA. Published: January 22, 2024. 2024 [cited 2025 May 8]. The American Heart Association Emergency Cardiovascular Care 2030 Impact Goals and Call to Action to Improve Cardiac Arrest Outcomes. Available from: https://professional.heart.org/en/science-news/the-aha-ecc-2030-impact-goals-and-call-to-action-to-improve-cardiac-arrest-outcomes

Datta R, Singh S. Artificial intelligence in critical care: Its about time! Med J Armed Forces India. 2021 Jul;77(3):266–75.

William P, Agrawal A, Rawat N, Shrivastava A, Srivastava AP, Ashish. Enterprise Human Resource Management Model By Artificial Intelligence Digital Technology. In: 2023 4th International Conference on Computation, Automation and Knowledge Management (ICCAKM). IEEE; 2023. p. 01–6.

Bansal K, Paliwal AC, Singh AK. Analysis of the benefits of artificial intelligence and human personality study on online fraud detection. International Journal of Law and Management. 2025 Jan 22;67(2):191–209.

Alamgir A, Mousa O, Shah Z. Artificial Intelligence in Predicting Cardiac Arrest: Scoping Review. JMIR Med Inform. 2021 Dec 17;9(12):e30798.

Byrsell F, Claesson A, Ringh M, Svensson L, Jonsson M, Nordberg P, et al. Machine learning can support dispatchers to better and faster recognize out-of-hospital cardiac arrest during emergency calls: A retrospective study. Resuscitation. 2021 May;162:218–26.

Secara IA, Hordiiuk D. Personalized Health Monitoring Systems: Integrating Wearable and AI. Journal of Intelligent Learning Systems and Applications. 2024;16(02):44–52.

Chan J, Rea T, Gollakota S, Sunshine JE. Contactless Cardiac Arrest Detection Using Smart Devices. 2019 Jan 31; Available from: http://arxiv.org/abs/1902.00062

Brown G, Conway S, Ahmad M, Adegbie D, Patel N, Myneni V, et al. Role of artificial intelligence in defibrillators: a narrative review. Open Heart. 2022 Jul 5;9(2):e001976.

Murk W, Goralnick E, Brownstein JS, Landman AB. Quality of Layperson CPR Instructions From Artificial Intelligence Voice Assistants. JAMA Netw Open. 2023 Aug 28;6(8):e2331205.

Abukhadijah HJ, Nashwan AJ. Transforming Hospital Quality Improvement Through Harnessing the Power of Artificial Intelligence. Global Journal on Quality and Safety in Healthcare. 2024 Aug 1;7(3):132–9.

Chen M, Decary M. Artificial intelligence in healthcare: An essential guide for health leaders. Healthc Manage Forum. 2020 Jan 24;33(1):10–8.

Lambert SI, Madi M, Sopka S, Lenes A, Stange H, Buszello CP, et al. An integrative review on the acceptance of artificial intelligence among healthcare professionals in hospitals. NPJ Digit Med. 2023 Jun 10;6(1):111.

American Hospital Association. AHA. 2025 [cited 2025 May 8]. Building and Implementing an Artificial Intelligence Action Plan for Health Care. Available from: https://www.aha.org/center/emerging-issues/market-insights/ai/building-and-implementing-artificial-intelligence-action-plan-health-care

Peterson J, Pearce PF, Ferguson LA, Langford CA. Understanding scoping reviews. J Am Assoc Nurse Pract. 2017 Jan;29(1):12–6.

Kajino K, Daya MR, Onoe A, Nakamura F, Nakajima M, Sakuramoto K, et al. Development and validation of a prehospital termination of resuscitation (TOR) rule for out-of-hospital cardiac arrest (OHCA) cases using general-purpose artificial intelligence (AI). Resuscitation. 2024 Apr 1;197.

Scquizzato T, Semeraro F, Swindell P, Simpson R, Angelini M, Gazzato A, et al. Testing ChatGPT ability to answer laypeople questions about cardiac arrest and cardiopulmonary resuscitation. Resuscitation. 2024 Jan 1;194.

Chin KC, Hsieh TC, Chiang WC, Chien YC, Sun JT, Lin HY, et al. Early recognition of a caller’s emotion in out-of-hospital cardiac arrest dispatching: An artificial intelligence approach. Resuscitation. 2021 Oct 1;167:144–50.

Blomberg SN, Christensen HC, Lippert F, Ersbøll AK, Torp-Petersen C, Sayre MR, et al. Effect of Machine Learning on Dispatcher Recognition of Out-of-Hospital Cardiac Arrest during Calls to Emergency Medical Services: A Randomized Clinical Trial. JAMA Netw Open. 2021 Jan 1;4(1).

Blomberg SN, Folke F, Ersbøll AK, Christensen HC, Torp-Pedersen C, Sayre MR, et al. Machine learning as a supportive tool to recognize cardiac arrest in emergency calls. Resuscitation. 2019 May 1;138:322–9.

Darginavicius L, Vencloviene J, Dobozinskas P, Vaitkaitiene E, Vaitkaitis D, Pranskunas A, et al. AI-Enabled Public Surveillance Cameras for Rapid Emergency Medical Service Activation in Out-of-Hospital Cardiac Arrests. Vol. 48, Current Problems in Cardiology. Elsevier Inc.; 2023.

Rafi S, Gangloff C, Paulhet E, Grimault O, Soulat L, Bouzillé G, et al. Out-of-Hospital Cardiac Arrest Detection by Machine Learning Based on the Phonetic Characteristics of the Caller’s Voice. In: Studies in Health Technology and Informatics. IOS Press BV; 2022. p. 445–9.

Harford S, Darabi H, Del Rios M, Majumdar S, Karim F, Vanden Hoek T, et al. A machine learning based model for Out of Hospital cardiac arrest outcome classification and sensitivity analysis. Resuscitation. 2019 May 1;138:134–40.

Isasi I, Jaureguibeitia X, Alonso E, Elola A, Aramendi E, Wik L. Artificial Intelligence for Multiclass Rhythm Analysis for Out-of-Hospital Cardiac Arrest During Mechanical Cardiopulmonary Resuscitation. Mathematics. 2025 Apr 1;13(8).

Cleve Andreas, Devillers Demitri, Palladini Mateo, Paris Jerome, Michael Rose, Faure Etienne, et al. Project Report : Detecting Out of Hospital Cardiac arrest Using Artificial Intelegence (Corti-EENA). 2020 Jan.

Cleve A, Devillers D, Palladini M, Paris J, Michael R, Faure E, et al. Detecting Out-of-Hospital cardiac arrest using artificial intelligence. Brussels: Euro pean Emergency Number Association. 2020;

Greenhalgh T, Abimbola S. The NASSS Framework A Synthesis of Multiple Theories of Technology Implementation. Stud Health Technol Inform. 2019;263:193–204.

Rodríguez-García A, Ruiz-García G, Navarro-Patón R, Mecías-Calvo M. Attitudes and Skills in Basic Life Support after Two Types of Training: Traditional vs. Gamification, of Compulsory Secondary Education Students: A Simulation Study. Pediatr Rep. 2024 Jul 30;16(3):631–43.

Hubail D, Mondal A, Al Jabir A, Patel B. Comparison of a virtual reality compression-only Cardiopulmonary Resuscitation (CPR) course to the traditional course with content validation of the VR course – A randomized control pilot study. Annals of Medicine & Surgery. 2022 Jan;73.

Okada Y, Mertens M, Liu N, Lam SSW, Ong MEH. AI and machine learning in resuscitation: Ongoing research, new concepts, and key challenges. Vol. 15, Resuscitation Plus. Elsevier B.V.; 2023.

Stefanouli M, Economou C. Data Protection in Smart Cities: Application of the EU GDPR. In 2019. p. 748–55.

Chen Z, Luo Y, Sra M. Engaging with AI: How Interface Design Shapes Human-AI Collaboration in High-Stakes Decision-Making. 2025 Jan 27; Available from: http://arxiv.org/abs/2501.16627

Seng KP, Ang LM. Embedded Intelligence: State-of-the-Art and Research Challenges. IEEE Access. 2022;10:59236–58.

Department of Homeland Security Science U, Directorate T. Artificial Intelligence-Facilitated Emergency Medical Services Call Center Software Market Survey Report [Internet]. 2023. Available from: www.dhs.gov/science-and-technology/saver-documents-library.

a

Published

01-08-2025

How to Cite

1.
Dalle H, Trisyani Y, Nuraeni A. Challenges and Opportunities of Artificial Intelligence Implementation in the Management of Out-of-Hospital Cardiac Arrest: Scoping Review. J. Health Nutr. Res [Internet]. 2025 Aug. 1 [cited 2025 Sep. 13];4(2):577-92. Available from: https://www.journalmpci.com/index.php/jhnr/article/view/429

Issue

Section

Articles

Similar Articles

You may also start an advanced similarity search for this article.