Abstract
AimsThe survival rate of sudden out-of-hospital cardiac arrests (OHCAs) increases by early notification of Emergency Medical Systems (EMS) and early application of basic life support (BLS) techniques and defibrillation. A Text Message (TM) alert system for trained volunteers in the community was implemented in the Netherlands to reduce response times. The aim of this study was to assess if this system improves survival after OHCA. Methods and ResultsFrom April 2012 to April 2014 data on all 1546 emergency calls for OHCA in the Dutch province of Limburg were collected according to the Utstein template. On site resuscitation attempts for presumed cardiac arrest were made in 833 cases, of which the TM-alert system was activated in 422 cases. Two cardiopulmonary resuscitation (CPR) scenarios were compared: 1. TM-alert system was activated but no responders attended (n=131), and 2. TM-alert system was activated with attendance of ≥1 responder(s) (n=291). Survival to hospital discharge was 16.0% in scenario 1 and 27.1% in scenario 2 corresponding with OR=1.95 (95% CI 1.15–3.33; P=.014). After adjustment for potential confounders the odds ratio increased (OR=2.82; 95% CI 1.52–5.24; P=.001). Of the 100 survivors, 92% were discharged from the hospital to their home with no or limited neurological sequelae. ConclusionThe TM-alert system is effective in increasing survival to hospital discharge in OHCA victims and the degree of disability or dependence after survival is low.
Highlights
Sudden out-of-hospital circulatory arrest (OHCA) is an important public health problem,[1,2] largely caused by cardiac disease.[3]
In a number of regions in the Netherlands, a novel system was introduced where citizen volunteers trained in resuscitation and the use of an Automatic External Defibrillator (AED) are notified by the Emergency Medical Systems (EMS) dispatch centre, using a text message (TM) notification, to go to an OHCA victim in their zip code based vicinity
In 411 (49.3%) cases the dispatch centre decided not to activate the system mostly because the ambulance was already nearby or present at the scene, or the OHCA occurred in a public place with an on-site AED These cases were excluded from the analysis
Summary
Sudden out-of-hospital circulatory arrest (OHCA) is an important public health problem,[1,2] largely caused by cardiac disease.[3] Survival rates are low[4,5,6] (
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