Effect of a first responder on survival outcomes after out-of-hospital cardiac arrest occurs during a period of exercise in a public place

Abstract

IntroductionThe deployment of first responders in a public place is one of the interventions that is used for increasing bystander cardiopulmonary resuscitation (CPR) of out-of-hospital cardiac arrests (OHCA). We studied the association between the presence of a first responder and the survival of OHCA that occurred during a period of exercise in a public place.MethodsAll of the adult OHCAs of a presumed cardiac etiology that occurred during a period of exercise in a public place and that were witnessed by a bystander between 2013 and 2015 were analyzed. The main exposure of interest was the characteristics of the bystander (first responder vs. layperson). The endpoints were the provision of bystander CPR and good neurological recovery. Multivariable logistic regression analysis, adjusting for patient-environment and prehospital factors, was performed.ResultsA total of 870 patients had a cardiac arrest during a period of exercise in a public place, and 58 (6.7%) patients were witnessed by the first responder. The OHCAs witnessed by first responders were more likely to result in bystander CPR than those witnessed by laypersons (89.7% vs. 75.4%, p = 0.01, adjusted OR (95% CI): 3.51 (1.44–8.55)). In terms of good neurological recovery, the OHCAs witnessed by first responders had a higher likelihood than the patients witnessed by laypersons (37.9% vs, 24.0%, p = 0.02, adjusted OR (95% CI): 2.92 (1.33–6.40)).ConclusionThe OHCAs occurred during a period of exercise in a public place and whom first responders witnessed were more likely to receive bystander CPR and to have a neurologically intact survival.

First-response treatment after out-of-hospital cardiac arrest: a survey of current practices across 29 countries in Europe

“…Fourth, our study showed that frequent CPR training is a feature of most FR-systems, as would be expected. Previous research has highlighted the superiority of off-duty medical professionals over laypersons [30] and more recent studies have shown the positive impact of trained citizen-responders on neurological outcomes [31]. Some regions allow citizen-responders to register as FRs without validating CPR-training (e.g., Denmark: Capital region and Central region), whereas CPR training is mandatory in two other regions in Denmark (Region Zealand and Region Southern Denmark).…”

Witnessed Cardiac Arrest by Nigerian Health Workers; Improving the Outcomes

“…In our locality, this is mostly through private arrangements using any available vehicle from family, friends or commercial taxis. It is a sharp contrast to what obtains in the western world where emergency dispatchers, fi rst responders, Basic Life Support (BLS) or Advanced Cardiac Life Support (ACLS) ambulances are engaged [4,5]. 5(1): 007-012.…”

Recruiting Medical Students for a First Responder Project in the Social Age: Direct Contact Still Outperforms Social Media

“…In other countries, either a medical background is required (e.g., Emergency Medical Services personnel, nurses, and doctors), or professionals with the duty of help are FRs (e.g., firemen, police officers, and security personnel) [4][5][6][7]. In some countries, FR systems combine these groups [8][9][10][11].…”

“…Early CPR and defibrillation have been shown to be effective to improve outcome after out-of-hospital cardiac arrests [6][7][8][9][10][11][12][13]. However, early CPR by trained CPR providers is critical, as the 1-month survival for patients suffering out-of-hospital cardiac arrests is higher if the rescuers are trained in CPR, compared to untrained bystanders [14].…”