Emergency medical services agencies in the US follow their own local protocols for out-of-hospital resuscitation for cardiac patients instead of American Heart Association’s national guidelines, according to a new research published in Circulation: Cardiovascular Quality and Outcomes.

Areas that provide incentives for hospital transport but not for efficient technologies and where cultural norms are perceived to impede termination of resuscitation go against the guidelines, the study said.

National organisations such as the American Heart Association and American College of Emergency Physicians can help address these barriers by coordinating with administrators and legislators.

Imparting knowledge to the public that quick transport to the hospital cannot substitute for optimal provision pre-hospital care would also act as a facilitator, researchers said.