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Background The Northern Ireland Ambulance Service (NIAS) attended 14,255 emergency calls for Out of Hospital Cardiac Arrests (OHCAs) over five-year period. The aim of this analysis was to explore the involvement of police and fire services in OHCAs in Northern Ireland.Methods A retrospective analysis of all OHCA calls attended by NIAS between 01/01/2018-31/12/2022 was conducted. Data was extracted from clinical and Computer Aided Dispatch records, cleaned, verified, and analysed.Results The Police Service of Northern Ireland (PSNI) were on scene for 7,054 (49.5%) calls and the Northern Ireland Fire and Rescue Service (NIFRS) 334 (2.3%) calls. Both attended 274 (1.9%) calls. CPR: Of the calls with PSNI/NIFRS on scene (n=7,124), 757 (10.6%) received CPR from the PSNI and/or NIFRS prior to the arrival of NIAS. CPR was initiated by PSNI/NIFRS in 470 (6.6%) calls with PSNI/NIFRS assisting in the remaining 287 (4.0%) calls prior to NIAS arrival. A yearly increase in the number of calls where CPR was performed by PSNI/NIFRS when in attendance was seen each year, rising from 11.8% in 2018 to 30.9% in 2022. NIAS attempted a resuscitation in 595 (78.6%) of calls where PSNI/NIFRS performed CPR, the remaining 162 (21.4%) had a recognition of life extinct (ROLE) declared on arrival of NIAS. Defibrillation: Defibrillation occurred in 99 (13.1%) of PSNI/NIFRS CPR attempted calls prior to NIAS arrival, 92 of which were delivered by the PSNI/NIFRS. Causes: Most calls attended by PSNI/NIFRS where they attempted CPR were of a medical cause (n=506, 66.8%). A higher proportion of NIFRS calls were due to trauma (34.7%) compared to 11.3% attended by the PSNI. When both were on scene and CPR was attempted, the most common cause was trauma (n=33, 41.3%).Conclusion PSNI/NIFRS are increasingly providing invaluable assistance in the management of OHCA prior to NIAS arrival.