P6382The use of a mobile GPS-tracking system to activate volunteer first responders increases survival among patients with out-of-hospital cardiac arrest in residential areas

Abstract

Abstract Background In residential areas, survival in patients with out-of-hospital cardiac arrest (OHCA) is less than one third compared with the survival in patients with OHCA in public areas. New strategies are needed to improve outcomes in residential areas. Purpose To evaluate the effect on survival in OHCA patients in residential vs. public areas, when using a mobile GPS-tracking system to activate volunteer first responders (VFRs). Methods In 2012 a mobile GPS-tracking system was brought into use by a first aid volunteer corps on a rural island with a population of about 12,000 inhabitants. In all cases of emergency calls where an emergency medical service (EMS) was requested, the system was activated. Three VFRs were recruited and successively provided with distinct VFR roles. One of the VFRs was guided to the nearest automatic external defibrillator before approaching the patient. We retrospectively screened all emergency ambulance journals in the years 2012–2017 to identify patients with OHCA. Additional information was collected from hospital records. Location was categorized as residential or public place. OHCAs witnessed by EMS, occurring at nursing homes or at uncertain locations were excluded. Clinical outcome was 30-day survival. Results During the 6-year period, there was a total of 114 OHCAs. Of these, 66 (57.9%) took place in residential areas, 16 (14.0%) in public areas and 32 (28.1%) were excluded. The 30-day survival in OHCA patients in residential vs. public areas was 15.2% and 12.5%, respectively (p=0.79). Demographic and survival results Residential area (n=66) Public area (n=16) P value Age, mean (SD) 71 (13) 69 (13) 0.14 Male sex, no. (%) 47 (71) 13 (87) 0.22 Volunteer first responder activated, no. (%) 55 (83) 15 (94) 0.30 AED arrives before EMS, no. (%) 36 (55) 9 (56) 0.34 Shock given before EMS, no. (%) 8/63 (13) 3/15 (20) 0.88 First rhythm shockable by EMS, no. (%) 11/64 (17) 3 (19) 0.63 30-day survival, no. (%) 10 (15) 2 (13) 0.79 The table shows the differences in OHCA located at residential areas versus public areas. AED: Automated external defibrillator; EMS: Emergency medical service; OHCA: Out-of-hospital cardiac arrest; SD: Standard deviation. Conclusion The use of a mobile GPS-tracking system to activate VFRs increases the 30-day survival among patients with OHCA in residential areas to a level comparable with the survival observed in public areas. Acknowledgement/Funding One year grant from Odense University Hospital's PhD Fund. One year grant from University of Southern Denmark. A 500,000 DKKR grant from TV2 Funen and OUH