Abstract
BackgroundIn Europe, survival rates after out-of-hospital cardiac arrest (OHCA) vary widely. Presence/absence and differences in implementation of systems dispatching First Responders (FR) in order to arrive before Emergency Medical Services (EMS) may contribute to this variation. A comprehensive overview of the different types of FR-systems used across Europe is lacking.MethodsA mixed-method survey and information retrieved from national resuscitation councils and national EMS services were used as a basis for an inventory. The survey was sent to 51 OHCA experts across 29 European countries.ResultsForty-seven (92%) OHCA experts from 29 countries responded to the survey. More than half of European countries had at least one region with a FR-system. Four categories of FR types were identified: (1) firefighters (professional/voluntary); (2) police officers; (3) citizen-responders; (4) others including off-duty EMS personnel (nurses, medical doctors), taxi drivers. Three main roles for FRs were identified: (a) complementary to EMS; (b) part of EMS; (c) instead of EMS. A wide variation in FR-systems was observed, both between and within countries.ConclusionsPolicies relating to FRs are commonly implemented on a regional level, leading to a wide variation in FR-systems between and within countries. Future research should focus on identifying the FR-systems that most strongly influence survival. The large variation in local circumstances across regions suggests that it is unlikely that there will be a ‘one-size fits all’ FR-system for Europe, but examining the role of FRs in the Chain of Survival is likely to become an increasingly important aspect of OHCA research.
Highlights
Out-of-hospital cardiac arrest (OHCA) is lethal within minutes of collapse if left untreated, and the majority of OHCA patients die before hospital admission [1, 2]
Types and roles of First Responders (FR) in Europe First responders were categorised post-hoc into four main types: 1) Firefighters (Fig. 1a) 2) Citizen-responders (Fig. 1b) 3) Police officers (Fig. 1c) 4) Others, i.e., all responders that could not be categorized into firefighters, citizen-responders, police officers
Key findings Our study shows the variety of FR-systems that have developed in Europe to expedite provision of good quality cardiopulmonary resuscitation (CPR) and defibrillation in case of an OHCA
Summary
Out-of-hospital cardiac arrest (OHCA) is lethal within minutes of collapse if left untreated, and the majority of OHCA patients die before hospital admission [1, 2]. If early cardiopulmonary resuscitation (CPR) is provided, survival rate increases [3, 4]. FR-systems have been implemented differently across Europe. Some countries have expanded the traditional EMS response with dispatch of CPR trained firefighters and police officers equipped with AEDs. Research has shown that the introduction of these types of dispatched FRs led to shorter response times [10], and increased 30 day survival [11, 12]. In Europe, survival rates after out-of-hospital cardiac arrest (OHCA) vary widely. Presence/absence and differences in implementation of systems dispatching First Responders (FR) in order to arrive before Emergency Medical Services (EMS) may contribute to this variation. A comprehensive overview of the different types of FRsystems used across Europe is lacking
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