Using firefighters as medical first responders to shorten response time in rural areas in Sweden

Abstract

Objective To map out and describe an earlier response by using firefighters as medical first responders on while waiting for the ambulance and first incident person assignments focusing on frequency, event time and survival >30 days after performed cardiopulmonary resuscitation. Design Retrospective descriptive design. Setting Ambulance service in a county of southern Sweden with a population of 200 000 inhabitants (23/km2). Participants Data were collected from four data systems within different organizations; emergency medical communication centre, fire deparment, ambulance services and conty hospital analysis unit. Main outcome measure(s) Data from 600 while waiting for the ambulance assignments, whereof 120 with first incident person present, collected between 1 January 2012 and 31 December 2016. Between 1 June 2014 and 1 October 2015, the two fire departments were dually dispatched on out‐of‐hospital cardiac arrests. Results Three main findings were made: there was a prolonged process time for dispatching fire fighters on while waiting for the ambulance assignments. Dual dispatches did not shorten the process time for dispatching full‐time firefighters, and, in a majority of while waiting for the ambulance assignments where cardiopulmonary resuscitation was performed, firefighters or first incident persons arrived first on the scene. Conclusion Minimising every minute that delays the performance of life‐saving actions is crucial. By dispatching firefighters on while waiting for the ambulance assignments in rural areas, the response time in a majority of assignments was shortened. However, there was substantial delay in dispatching firefighters due to prolonged process time at the emergency medical communication centre. The emergency medical communication centre operator's ability to quickly assess the need for while waiting for the ambulance assignments plays a crucial role in the chain of survival.

Prehospital Time Interval for Urban and Rural Emergency Medical Services: A Systematic Literature Review

“…This encourages conducting further studies per country to help healthcare officials enhance their interventions. In this context, a previous study indicated that using firefighters as medical first responders enhances pre-hospital time and patient outcomes in Sweden [ 55 ]. Moreover, in South Korea, the National Ambulance Service suggested that EMS for specific events (like cardiac arrest) might be conducted by moderate care ambulances and non-front-line officers to reduce response time, as such events might not require high levels of training and management resources, which might save time in those situations [ 56 ].…”

A review on initiatives for the management of daily medical emergencies prior to the arrival of emergency medical services

“…( 2019 ) and Svensson et al. ( 2020 ) Shuster and Keller ( 1993 ), White et al. ( 1998 ), Jermyn ( 2000 ), Smith et al.…”

Voluntary first responders’ experiences of being dispatched to suspected out-of-hospital cardiac arrest in rural areas: an interview study

“…The European Resuscitation Council guidelines emphasise the importance of using technology such as text messages or smartphone applications to alert voluntary first responders (VFRs) to suspected OHCAs and improve the rate of bystander CPR [ 5 ]. This is important, as prolonged response time for EMS arrival is common [ 6 , 7 ], and time to CPR significantly affects survival outcomes [ 8 , 9 ]. In Sweden, the ambulance response time in the case of OHCA has significantly increased over time, from 5 min in the early 1990s to 12 min in 2020 [ 10 ].…”