Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2021

Open Access 01-12-2021 | Cardiopulmonary Resuscitation | Original research

Smartphone-based dispatch of community first responders to out-of-hospital cardiac arrest - statements from an international consensus conference

Authors: Camilla Metelmann, Bibiana Metelmann, Dorothea Kohnen, Peter Brinkrolf, Linn Andelius, Bernd W. Böttiger, Roman Burkart, Klaus Hahnenkamp, Mario Krammel, Tore Marks, Michael P. Müller, Stefan Prasse, Remy Stieglis, Bernd Strickmann, Karl Christian Thies

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2021

Login to get access

Abstract

Background

Over the past decade Smartphone-based activation (SBA) of Community First Responders (CFR) to out-of-hospital cardiac arrests (OHCA) has gained much attention and popularity throughout Europe. Various programmes have been established, and interestingly there are considerable differences in technology, responder spectrum and the degree of integration into the prehospital emergency services. It is unclear whether these dissimilarities affect outcome. This paper reviews the current state in five European countries, reveals similarities and controversies, and presents consensus statements generated in an international conference with the intention to support public decision making on future strategies for SBA of CFR.

Methods

In a consensus conference a three-step approach was used: (i) presentation of current research from five European countries; (ii) workshops discussing evidence amongst the audience to generate consensus statements; (iii) anonymous real-time voting applying the modified RAND-UCLA Appropriateness method to adopt or reject the statements. The consensus panel aimed to represent all stakeholders involved in this topic.

Results

While 21 of 25 generated statements gained approval, consensus was only found for 5 of them. One statement was rejected but without consensus. Members of the consensus conference confirmed that CFR save lives. They further acknowledged the crucial role of emergency medical control centres and called for nationwide strategies.

Conclusions

Members of the consensus conference acknowledged that smartphone-based activation of CFR to OHCA saves lives. The statements generated by the consensus conference may assist the public, healthcare services and governments to utilise these systems to their full potential, and direct the research community towards fields that still need to be addressed.
Appendix
Available only for authorised users
Literature
1.
Perkins GD, Handley AJ, Koster RW, Castrén M, Smyth MA, Olasveengen T, et al. European resuscitation council guidelines for resuscitation 2015: section 2. Adult basic life support and automated external defibrillation. Resuscitation. 2015;95:81–99.CrossRef
2.
Hasselqvist-Ax I, Riva G, Herlitz J, Rosenqvist M, Hollenberg J, Nordberg P, et al. Early cardiopulmonary resuscitation in out-of-hospital cardiac arrest. N Engl J Med. 2015;372(24):2307–15.CrossRef
3.
Rajan S, Wissenberg M, Folke F, Hansen SM, Gerds TA, Kragholm K, et al. Association of Bystander Cardiopulmonary Resuscitation and Survival According to ambulance response times after out-of-hospital cardiac arrest. Circulation. 2016;134(25):2095–104.CrossRef
4.
Zijlstra JA, Stieglis R, Riedijk F, Smeekes M, van der Worp WE, Koster RW. Local lay rescuers with AEDs, alerted by text messages, contribute to early defibrillation in a Dutch out-of-hospital cardiac arrest dispatch system. Resuscitation. 2014;85(11):1444–9.CrossRef
5.
Kindness P, Fitzpatrick D, Mellish C, Masthoff J, O'Meara P, McEwan M. An insight into the demands and stressors experienced by community first responders. Journal of Paramedic Practice. 2014;6(7):362–9.CrossRef
6.
Roberts A, Nimegeer A, Farmer J, Heaney DJ. The experience of community first responders in co-producing rural health care: in the liminal gap between citizen and professional. BMC Health Serv Res. 2014;14:460.CrossRef
7.
Phung V-H, Trueman I, Togher F, Orner R, Siriwardena AN. Community first responders and responder schemes in the United Kingdom: systematic scoping review. Scand J Trauma Resusc Emerg Med. 2017;25(1):58.CrossRef
8.
Weir A. Community first responders: improving access to defibrillation in cardiac arrest. Journal of Paramedic Practice. 2015;7(3):114–6.CrossRef
9.
Heffernan E, Oving I, Barry T, Phung V-H, Siriwardena AN, Masterson S. Factors that motivate individuals to volunteer to be dispatched as first responders in the event of a medical emergency: a systematic review protocol. HRB Open Res. 2019;2:34.CrossRef
10.
Timmons S, Vernon-Evans A. Why do people volunteer for community first responder groups? Emerg Med J. 2013;30(3):e13.CrossRef
11.
Hasselqvist-Ax I, Nordberg P, Herlitz J, Svensson L, Jonsson M, Lindqvist J, et al. Dispatch of firefighters and police officers in out-of-hospital cardiac arrest: a nationwide prospective cohort trial using propensity score analysis. J Am Heart Assoc. 2017;6(10):1–8.
12.
13.
14.
Ringh M, Rosenqvist M, Hollenberg J, Jonsson M, Fredman D, Nordberg P, et al. Mobile-phone dispatch of laypersons for CPR in out-of-hospital cardiac arrest. N Engl J Med. 2015;372(24):2316–25.CrossRef
15.
Andelius L, Malta Hansen C, Lippert FK, Karlsson L, Torp-Pedersen C, Kjær Ersbøll A, et al. Smartphone activation of citizen responders to facilitate defibrillation in out-of-hospital cardiac arrest. J Am Coll Cardiol. 2020;76(1):43–53.CrossRef
16.
Pijls RWM, Nelemans PJ, Rahel BM, Gorgels APM. A text message alert system for trained volunteers improves out-of-hospital cardiac arrest survival. Resuscitation. 2016;105:182–7.CrossRef
17.
Oving I, Masterson S, Tjelmeland IBM, Jonsson M, Semeraro F, Ringh M, et al. First-response treatment after out-of-hospital cardiac arrest: a survey of current practices across 29 countries in Europe. Scand J Trauma Resusc Emerg Med. 2019;27(1):112.CrossRef
18.
Krammel M, Lobmeyr E, Sulzgruber P, Winnisch M, Weidenauer D, Poppe M, et al. The impact of a high-quality basic life support police-based first responder system on outcome after out-of-hospital cardiac arrest. PLoS One. 2020;15(6):e0233966.CrossRef
19.
Ringh M, Fredman D, Nordberg P, Stark T, Hollenberg J. Mobile phone technology identifies and recruits trained citizens to perform CPR on out-of-hospital cardiac arrest victims prior to ambulance arrival. Resuscitation. 2011;82(12):1514–8.CrossRef
20.
Caputo ML, Muschietti S, Burkart R, Benvenuti C, Conte G, Regoli F, et al. Lay persons alerted by mobile application system initiate earlier cardio-pulmonary resuscitation: a comparison with SMS-based system notification. Resuscitation. 2017;114:73–8.CrossRef
21.
22.
Saner H, Morger C, Eser P, von Planta M. Dual dispatch early defibrillation in out-of-hospital cardiac arrest in a mixed urban-rural population. Resuscitation. 2013;84(9):1197–202.CrossRef
23.
Hansen CM, Kragholm K, Granger CB, Pearson DA, Tyson C, Monk L, et al. The role of bystanders, first responders, and emergency medical service providers in timely defibrillation and related outcomes after out-of-hospital cardiac arrest: results from a statewide registry. Resuscitation. 2015;96:303–9.CrossRef
24.
Nordberg P, Hollenberg J, Rosenqvist M, Herlitz J, Jonsson M, Järnbert-Petterson H, et al. The implementation of a dual dispatch system in out-of-hospital cardiac arrest is associated with improved short and long term survival. Eur Heart J Acute Cardiovasc Care. 2014;3(4):293–303.CrossRef
25.
Husain S, Eisenberg M. Police AED programs: a systematic review and meta-analysis. Resuscitation. 2013;84(9):1184–91.CrossRef
26.
Pijls RW, Nelemans PJ, Rahel BM, Gorgels AP. Factors modifying performance of a novel citizen text message alert system in improving survival of out-of-hospital cardiac arrest. Eur Heart J Acute Cardiovasc Care. 2018;7(5):397–404.CrossRef
27.
Fitch K, Bernstein S, Aguilar MD, Burnand B, LaCalle JR, Lazaro P, et al. The Rand UCLA appropriateness method user's manual: prepared for directorate general XII, European Commission. Santa Monica: Rand Corp; 2001. (MR-1269-DG-XII/RE)
28.
Chugh SS, Jui J, Salvucci A. Pivotal role in the community response to cardiac arrest: the smart bystander∗. J Am Coll Cardiol. 2020;76(1):54–6.CrossRef
29.
Campbell A, Ellington M. Reducing time to first on scene: an ambulance-community first responder scheme. Emerg Med Int. 2016;2016:1915895.CrossRef
30.
Smith CM, Wilson MH, Hartley-Sharpe C, Gwinnutt C, Dicker B, Perkins GD. The use of trained volunteers in the response to out-of-hospital cardiac arrest - the GoodSAM experience. Resuscitation. 2017;121:123–6.CrossRef
31.
Phung V-H, Trueman I, Togher F, Ørner R, Siriwardena AN. Perceptions and experiences of community first responders on their role and relationships: qualitative interview study. Scand J Trauma Resusc Emerg Med. 2018;26(1):13.CrossRef
32.
Hasselqvist-Ax I, Nordberg P, Svensson L, Hollenberg J, Joelsson-Alm E. Experiences among firefighters and police officers of responding to out-of-hospital cardiac arrest in a dual dispatch programme in Sweden: an interview study. BMJ Open. 2019;9(11):e030895.CrossRef
33.
Nordberg P, Jonsson M, Forsberg S, Ringh M, Fredman D, Riva G, et al. The survival benefit of dual dispatch of EMS and fire-fighters in out-of-hospital cardiac arrest may differ depending on population density--a prospective cohort study. Resuscitation. 2015;90:143–9.CrossRef
34.
Holmberg M, Holmberg S, Herlitz J. Factors modifying the effect of bystander cardiopulmonary resuscitation on survival in out-of-hospital cardiac arrest patients in Sweden. Eur Heart J. 2001;22(6):511–9.CrossRef
35.
Herlitz J, Svensson L, Holmberg S, Angquist K-A, Young M. Efficacy of bystander CPR: intervention by lay people and by health care professionals. Resuscitation. 2005;66(3):291–5.CrossRef
36.
Nord A, Svensson L, Karlsson T, Claesson A, Herlitz J, Nilsson L. Increased survival from out-of-hospital cardiac arrest when off duty medically educated personnel perform CPR compared with laymen. Resuscitation. 2017;120:88–94.CrossRef
37.
Del Giudice D, Semeraro F, Ristagno G, Picoco C, Cordenons F, Dell'Arciprete O, et al. DAE RespondER: the Emilia Romagna app for a regional “community saving lives” system. Resuscitation. 2019;145:34–6.CrossRef
38.
Harrison-Paul R, Timmons S, van Schalkwyk WD. Training lay-people to use automatic external defibrillators: are all of their needs being met? Resuscitation. 2006;71(1):80–8.CrossRef
39.
Zijlstra JA, Beesems SG, de Haan RJ, Koster RW. Psychological impact on dispatched local lay rescuers performing bystander cardiopulmonary resuscitation. Resuscitation. 2015;92:115–21.CrossRef
40.
Scquizzato T, Pallanch O, Belletti A, Frontera A, Cabrini L, Zangrillo A, et al. Enhancing citizens response to out-of-hospital cardiac arrest: a systematic review of mobile-phone systems to alert citizens as first responders. Resuscitation. 2020;152:16–25.CrossRef
41.
Auricchio A, Gianquintieri L, Burkart R, Benvenuti C, Muschietti S, Peluso S, et al. Real-life time and distance covered by lay first responders alerted by means of smartphone-application: implications for early initiation of cardiopulmonary resuscitation and access to automatic external defibrillators. Resuscitation. 2019;141:182–7.CrossRef
42.
Stieglis R, Zijlstra JA, Riedijk F, Smeekes M, van der Worp WE, Koster RW. AED and text message responders density in residential areas for rapid response in out-of-hospital cardiac arrest. Resuscitation. 2020.
43.
McBride R, Ski CF, Thompson DR, Quinn T, Wilson MH. Championing survival: connecting the unknown network of responders to address out-of-hospital cardiac arrest. Scand J Trauma Resusc Emerg Med. 2020;28(1):49.CrossRef
44.
Farmer J, Currie M, Kenny A, Munoz S-A. An exploration of the longer-term impacts of community participation in rural health services design. Soc Sci Med. 2015;141:64–71.CrossRef
Metadata
Title
Smartphone-based dispatch of community first responders to out-of-hospital cardiac arrest - statements from an international consensus conference
Authors
Camilla Metelmann
Bibiana Metelmann
Dorothea Kohnen
Peter Brinkrolf
Linn Andelius
Bernd W. Böttiger
Roman Burkart
Klaus Hahnenkamp
Mario Krammel
Tore Marks
Michael P. Müller
Stefan Prasse
Remy Stieglis
Bernd Strickmann
Karl Christian Thies
Publication date
01-12-2021
Publisher
BioMed Central
DOI
https://doi.org/10.1186/s13049-021-00841-1

Other articles of this Issue 1/2021

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2021 Go to the issue

Original research

Standardized post-resuscitation damage assessment of two mechanical chest compression devices: a prospective randomized large animal trial

Original research

Prehospital identification of Covid-19: an observational study

Original research

Alcohol and trauma: the influence of blood alcohol levels on the severity of injuries and outcome of trauma patients - a retrospective analysis of 6268 patients of the TraumaRegister DGU®

Original research

Incidence of hyperoxia in trauma patients receiving pre-hospital emergency anaesthesia: results of a 5-year retrospective analysis

Original research

Incorporating a real-time automatic alerting system based on electronic medical records could improve rapid response systems: a retrospective cohort study

Original research

Intraosseous versus intravenous vascular access during cardiopulmonary resuscitation for out-of-hospital cardiac arrest: a systematic review and meta-analysis of observational studies