Professional firefighter and trained volunteer first-responding units in emergency medical service.

Abstract

Although widely dispatched to out-of-hospital cardiac arrests, the performance of prehospital first-responding units in other medical emergencies is unknown. In this retrospective, descriptive study, the general performance of 44 first-responding units in Pirkanmaa County, Finland, were examined. A subgroup analysis compared the first-responding units made up of professional firefighters and trained volunteers. First-responding units were dispatched to patients during 1622 missions between 1 January 2013 and 31 December 2013. The median time to reach the scene was 9minutes in any mission. Overall, first responders evaluated 1015 patients and provided treatment or assisted ambulance personnel in 793 (78%) cases. The most common treatment modalities were assistance, such as carrying (22%) and the administration of supplemental oxygen (19%). There were 83 resuscitation attempts during the time period. In 42 of these, first-responding units initiated basic life support a median of 4minutes prior to the arrival of ambulance personnel. Return of spontaneous circulation was achieved in 20% of cases. The subgroup analysis showed that trained volunteers administered oxygen more liberally than professional firefighters in stroke and chest pain mission (stroke: professional 9/236 cases [4%] vs layperson 26/181 cases [14%], P<0.001; chest pain: professional 16/78 cases [21%] vs layperson 77/159 cases [48%], P<0.001). First-responding units provided initial treatment or assistance to ambulance personnel in approximately half of the missions. Implementation of professional- and layperson-staffed first-responding units in emergency medical service system seems to be feasible.