Cardiac arrest: faster defibrillation thanks to smartphone app

Insight

• If randomly present first responders arrive at the site of a cardiac arrest outside the hospital due to a smartphone warning from the emergency services (OHCA), patients are more likely to receive defibrillation by first responders.
• An increased program for volunteer first responders could increase the defibrillation rate after an OHCA.
• Currently, a Study is currently being conducted to investigate whether survival is negatively affected.

Why this matters

• Early defibrillation is critical for survival of OHCA with shockable rhythm.
• Because automated external defibrillators-_(AEDs) are often not available in residential areas, an OHCA at home is particularly deadly.
• Response times from emergency services may be too long to provide effective defibrillation.

Study design

• Retrospective study (2017–2019) with prospective OHCA data in the Stockholm region of Sweden and in the Danish capital region (n = 1.271 OHCAs).
• The authors examined the use of a smartphone app-based program for volunteer first responders.
• The control center alerted 20–30  First responders who were nearby and who were asked to start resuscitation or a  AED.
• Result: First responder defibrillation
• Funding: TrygFonden

Key results

• 81.0 % of OHCAs occurred in private homes.
• In 37.0 % of the home-based and 34.7 % of the OHCAs appearing in public, the first responders were on site before the emergency services.
• Percentage of patients undergoing defibrillation by first-arriving first responder-vs.received the first emergency services:
  • at home: 15.5 % vs. 2,2 % (p <0.001)
  • In public: 32,1 % vs. 19,6 % (p = 0,030)
• As the response times of the rescue service increased, the likelihood of defibrillation by first responders also increased.
• However, the 30-day survival rate did not differ between first responders arriving first responders and emergency services arriving first.

• at home: 15.5 % vs. 2,2 % (p <0.001)
• In public: 32,1 % vs. 19,6 % (p = 0,030)

Limitations

• The study may not have been conclusive enough to detect an effect on survival.
• The authors could not determine how many minutes the first responders arrived before the emergency services.
• These countries already have a culture of heavy use of first responders, so the results may not be generalizable to other environments.

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