A scoping review of support interventions for bystanders involved in out-of-hospital cardiac arrest

Bystanders witnessing or performing cardiopulmonary resuscitation (CPR) during out-of-hospital cardiac arrest (OHCA) may experience significant psychological distress. Although the need to support bystanders after OHCA is increasingly recognised, existing post-event support interventions have not been previously described.

To identify and describe existing post-event support interventions for bystanders involved in OHCA.

A scoping review was conducted using Joanna Briggs Institute methodology and PRISMA-ScR reporting. Databases and grey literature were searched from inception to March 2026 for sources describing post-event support interventions for adult OHCA bystanders. Data were charted and synthesised descriptively.

Sixteen peer-reviewed articles or published studies, pertaining to eleven support interventions were included, alongside three additional interventions identified through grey literature, giving a total of fourteen interventions. Most interventions were developed in the past decade in high-income Western countries. Support mainly consisted of information-giving and debriefing, which could be delivered on scene, shortly after the event via telephone or in person, or through digital platforms. Promotional methods included on-scene written materials, emergency medical service dispatcher- or clinician-initiated contact, app-triggered messages, and public-facing websites or social media. Only five studies reported participant outcomes, with two assessing psychological distress. No study evaluated intervention effectiveness.

New support interventions for bystanders involved in OHCA are emerging, particularly in Western countries. The most common component of these interventions is information-giving, with the majority also providing debriefing and psychological support. However, more research is needed on the most effective ways to promote these interventions and on the effects of these interventions on outcomes important to bystanders.