EMS System Performance for Sudden Cardiac Arrest in Malang - Indonesia

Introduction: Sudden cardiac arrest (SCA) represents a significant public health challenge characterized by a high mortality rate. Timely resuscitation is essential for survival, highlighting the critical role of the emergency medical services (EMS) system in improving patient outcomes. This study aims to examine the performance of the EMS system in managing SCA cases in Malang, Indonesia, with a focus on identifying the factors that contribute to limitations in its effectiveness. Materials and methods: This study evaluates the performance gaps of the EMS system based on key interventions outlined by the Global Resuscitation Alliance (GRA). A qualitative design was employed, involving nine key informants, with data collected through observations, supporting documentation of all SCA cases managed by EMS, and interviews. Thematic analysis was used to identify key themes, with data analyzed through reduction, presentation, and conclusion drawing. Results: Time metrics recording recommended by GRA had not been completely implemented because lack of protocol and evaluation by the department resulted in officers' doubts in recording. The GRA performance metrics had never been put into practise because lack of equipment and knowledge resulting in lacking of confidence of the officer in carrying out life support measures. Conclusion: A gap analysis of the GRA key elements for EMS revealed limitations in the EMS system's performance in managing prehospital SCA cases in Malang, Indonesia. Improvement strategies are necessary to enhance EMS effectiveness and achieve a higher survival rate for SCA patients.