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6% to 82.4% (p trend 0.001). The frequency of EMS trauma-specific interventions increased over the study period, including needle thoracostomy from 7.7% to 61.6% (p trend 0.001). Although the risk-adjusted odds of ROSC (OR 1.06, 95% CI 1.03-1.1 and event survival (OR 1.05, 95% CI 1.01-1.09) increased year-on-year, there were no temporal changes in survival to hospital discharge. Despite higher rates of bystander CPR and EMS trauma interventions, rates of survival following traumatic OHCA did not change over time in our regio