RACE-CARS
five years of CPR education, dispatcher training and extra AEDs in 31 North Carolina counties did not yield more survivors with good brain function than usual practice in 29 others
Presented in LBS.04 at AHA 2026 (Sunday 8 November) and published simultaneously in NEJM. RACE-CARS is a cluster-randomised trial of 60 North Carolina counties (about 8.5 million residents), 31 randomised to a comprehensive community and EMS intervention (community CPR training, dispatcher-assisted CPR training, enhanced first-responder defibrillation, 405 trial-provided AEDs) and 29 to usual practice, July 2021 to June 2026. Among 22,459 adults with out-of-hospital cardiac arrest (11,615 intervention, 10,844 control; median age 64, 37 percent women, 29 percent rural), survival to discharge with favourable neurological function was about 9 versus 9.4 percent (not significant). Bystander CPR 44.8 versus 42.3 percent, defibrillation before EMS arrival 13.5 versus 15.3 percent. In an exploratory analysis of the final year the odds of bystander CPR were 33 percent higher in intervention counties. Training reached 201,586 people, 4.8 percent of residents. Figures from the AHA news release; the NEJM paper is not yet readable to us.
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