Moving the dial on out-of-hospital cardiac arrest survival in Aotearoa New Zealand.

Out-of-hospital cardiac arrest (OHCA) remains a major public health challenge in Aotearoa New Zealand, with 30-day survival plateauing at approximately 11% in recent years. Registry data demonstrate that early bystander cardiopulmonary resuscitation (CPR) and community defibrillation significantly increase survival, yet community defibrillation rates remain low, and inequities persist across ethnicity, gender, deprivation and rurality. International evidence shows that system-level improvements in early response and equitable access to post-arrest care can substantially improve outcomes. Improving OHCA survival in New Zealand requires a co-ordinated, equity-focussed strategy centered on universal CPR literacy, automated external defibrillator (AED) training, targeted AED deployment and maintenance of a national registry, strengthened community-responder systems and optimisation of cardiac arrest care pathways.