In September 2025, the East of England Ambulance Service NHS Trust (EEAST) became the first ambulance service in the UK to use live video during out-of-hospital cardiac arrests (OHCA).
Thanks to a grant awarded to the EEAST Charity by NHS Charities Together, a dedicated OHCA desk pilot was launched within the emergency operations centre (EOC). The pilot focuses on improving the quality of CPR delivered to patients, ensuring the most appropriate response, supporting rescuers following resuscitation attempts, and providing dedicated clinical advice throughout OHCA incidents.
Staffed by advanced paramedics, the OHCA desk uses live video technology through GoodSAM Instant-on-Scene, enabling clinicians to see in real time what is happening at the scene. This allows them to support bystanders in delivering high-quality CPR, guide defibrillator use, facilitate earlier life-saving interventions and support decision-making around resuscitation.
High-quality CPR and early defibrillation are two of the most important factors influencing survival from cardiac arrest. Historically, however, ambulance services have had limited visibility of the quality of CPR being delivered before crews arrive on scene. Live video has helped close this gap, allowing advanced paramedics to provide tailored guidance on CPR rate, depth, hand position, chest recoil, compression fraction, and defibrillator application and use.
Since the launch of the pilot, the OHCA desk has reviewed 3,445 cardiac arrest calls and delivered 1,000 direct clinical interventions, including 237 live video activations. These interventions have led to 457 measurable improvements in CPR or defibrillation delivery. In almost every case, advanced paramedics have been able to guide rescuers to provide higher-quality CPR.
Beyond improving CPR and defibrillator use, video support has had a significant impact on caller confidence during highly traumatic situations. It has helped reassure rescuers that they have done everything possible to help the patient, even in cases where resuscitation was ultimately unsuccessful.
The programme has also introduced a dedicated aftercare support service for rescuers. Specialist aftercare paramedics contact rescuers following a resuscitation attempt to provide reassurance, signposting and an opportunity to discuss their experience. Feedback has been overwhelmingly positive, with many rescuers expressing gratitude and surprise that such support was available.
The OHCA desk has also transformed how the trust manages cardiac arrest calls operationally. Advanced paramedics review suspected cardiac arrest calls in real time, helping determine the most appropriate response and identify situations where resuscitation may not be clinically appropriate. This supports a more personalised and clinically informed response for patients and their families.
While the primary aim of the pilot was to improve CPR for viable out-of-hospital cardiac arrests, the involvement of clinicians at the point of call has also enabled the service to provide dignity and compassion in death, while supporting callers through some of the most distressing moments of their lives. An additional benefit has been a reduction in inappropriate resuscitation attempts and more effective use of ambulance resources.
The success of the pilot has led EEAST to commit to expanding the service to a seven-day-a-week operation as part of its advanced paramedic programme. The video CPR pilot has also been shared with ambulance services across the UK, generating significant interest in wider adoption.
For more information contact Liam Sagi, AACE National Strategic Lead for Out-of-Hospital Cardiac Arrest via liam.sagi@aace.org.uk.
