Time is the crucial factor in the “chain of survival” for out-of-hospital cardiac arrest (OHCA). Researchers from the Centre for Resuscitation Science, Karolinska Institutet, Sweden recently measured different response time intervals by comparing emergency medical services (EMS), firefighters, and smartphone aided volunteer responders in two large Swedish regions.
Volunteer responders were timed from the alert until they arrived at the scene of the suspected OHCA. The first arriving volunteer responders who tried to retrieve an automated external defibrillator (AED-responder) and who ran to perform bystander cardiopulmonary resuscitation (CPR-responder) were compared to both the first arriving EMS and firefighters. Three-time intervals were measured, from call to dispatch, the unit response time (from dispatch to arrival), and the total response time.
During the course of 22 months, 2,631 suspected OHCAs were reviewed. Researchers found that first arriving volunteer responders had the shortest unit response time when compared to both firefighters and EMS. This advantage, however, was reduced by delays introduced at the dispatch center. Earlier automatic dispatch should be considered in further studies.
The authors suggest that to reduce the time to dispatch of additional resources, such as firefighters and volunteer responders, the dispatch should be simultaneous to the dispatch of EMS, if not earlier. This study may contribute as baseline data for a randomized study comparing response times for earlier automatic activation simultaneously with the first EMS versus today’s dispatcher-initiated activation.
A disadvantage to an automatic dispatch may be that the volunteer responders could be dispatched to unsafe or objectionable situations. Another problem could be that the volunteers as a group would be dispatched more often, also when not needed. A cautious approach should be taken to ensure the wellbeing and motivation of volunteer responders.
Further, they recommend that to reduce the unit response time, AED deployment, preferably outdoors with 24/7 access, should be increased. In addition, an increased focus should be directed to place AEDs in residential areas where the majority of OHCAs occur. Solutions such as drones, could play an important part in reaching the full potential of volunteer responder systems. If the volunteer responders did not have to run the “extra mile” to retrieve an AED, they could reach the scene several minutes before EMS and firefighters and equipment could instead be flown in to assist.