First responder resuscitation teams in a rural Norwegian community: sustainability and self-reports of meaningfulness, stress and mastering

Abstract

BackgroundTraining of lay first responder personnel situated closer to the potential victims than medical professionals is a strategy potentially capable of shortening the interval between collapse and start of cardiopulmonary resuscitation (CPR) in cases of out-of-hospital cardiac arrest. In this study we trained lay first responders personnel in basic life support (BLS) and defibrillation for cases of cardiac arrest and suspected acute myocardial infarction (AMI).MethodsForty-two lay first responders living in remote areas or working in industries in the island community of Austevoll, Western Norway, were trained in CPR and defibrillation. We placed particular emphasis on the first responders being able to defibrillate a primary ventricular fibrillation (PVF) in patients with AMI. The trainees were organised in four teams to attend victims of AMI and cardiac arrest while awaiting the arrival of the community emergency medical services. The purpose of the study was to find out whether the teams were able to function during the five-year study project, and to examine whether lives could be saved. The first responders completed questionnaires each year on their experiences of participation. Data on the medical actions of the teams were also collected.ResultsBy the end of the project all groups were functioning. The questionnaires evidenced a reasonable degree of motivation and self-evaluated competence in both types of group organisation, but in spite of this attrition effects in the first responders were considerable. The first responders were called out on 24 occasions, for a total of 17 patients. During the study period no case of PVF occurred after the arrival of the first responders, and the number of AMIs was very low, strongly deviating from what was anticipated. No lives were saved by the project.ConclusionsThe teams were sustained for almost five years without any significant deterioration of self-reported stress or mastering, but still showed attrition effects. Evaluated as a medical project the intervention was not successful, but the small scale prevents us from drawing firm conclusions on this aspect.

Smartphone-based dispatch of Community First Responders to Out-of-Hospital Cardiac Arrest - Statements from an International Consensus Conference

“…Hence, we might need to adapt CFR systems to differing regional demands (32). One approach in rural areas could be to build a tighter net by recruiting not only CFR with a medical background, but also laypersons, because there are not enough medically trained CFR to cover rural areas su ciently (37). This clearly is a eld for further research.…”

Policía costera de Vigo. Estudio piloto cuasi-experimental sobre rescate y RCP / Coastal Police of Vigo. A Quasi-Experimental Pilot Study about Rescue and CPR

“…Aun así, se debería implementar un entrenamiento para un desempeño de mayor duración, ya que el tiempo de respuesta de los servicios de emergencias puede llegar incluso hasta los 20 minutos (26), dependiendo de la ubicación y la descripción de la localización exacta de la emergencia (27). Por lo tanto, se recomienda capacitar y entrenar a los agentes de policía y bomberos (9), ya que están más cerca de las situaciones de emergencias en playas que los SEM (12). Esto podría reducir la incidencia de muertes por ahogamiento, bien interrumpiendo el proceso de sumersión en el agua o bien iniciando la RCP de forma precoz, aumentando las posibilidades de supervivencia de una persona que sufrió un paro cardíaco (8,(28)(29)(30).…”

“…De la rapidez respuesta al incidente y de la aplicación de la RCP precoz, se podría contribuir a reducir el colapso en el paro cardíaco, aumentando así la probabilidad de supervivencia (12). Una RCP precoz de calidad también reduce el daño a nivel neurológico (8,13), por eso el Consejo Europeo de Resucitación (14) y la Asociación Americana del Corazón (15) promueven la RCP de calidad, de aquí la relevancia de instruir y evaluar a los potenciales primeros intervinientes.…”

Mobile phone-based alerting of CPR-trained volunteers simultaneously with the ambulance can reduce the resuscitation-free interval and improve outcome after out-of-hospital cardiac arrest: A German, population-based cohort study

“…Training of first responder personnel located closer than medical professionals to the victims is a strategy potentially capable of shortening the resuscitation-free interval. 3,10 Modern variants of the "First-Responder" concept are based on use of mobile phone positioning systems and smartphone applications for locating and alerting nearby trained volunteers in cases of OHCA. Although such systems are helpful to significantly increase rates of bystander-initiated-CPR among patients with OHCA, 10 little is known about the impact on outcome parameters such as return-of-spontaneous-circulation (ROSC), survival rate, and brain function after cardiac arrest.…”