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. 2019 Dec 16;27(1):112.
doi: 10.1186/s13049-019-0689-0.

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

Iris Oving  1 , Siobhan Masterson  2 , Ingvild B M Tjelmeland  3 , Martin Jonsson  4 , Federico Semeraro  5 , Mattias Ringh  4 , Anatolij Truhlar  6 , Diana Cimpoesu  7 , Fredrik Folke  8   9 , Stefanie G Beesems  1 , Rudolph W Koster  1 , Hanno L Tan  10   11 , Marieke T Blom  1 ; ESCAPE-NET Investigators
Affiliations

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

Iris Oving et al. Scand J Trauma Resusc Emerg Med. .

Abstract

Background: In Europe, survival rates after out-of-hospital cardiac arrest (OHCA) vary widely. Presence/absence and differences in implementation of systems dispatching First Responders (FR) in order to arrive before Emergency Medical Services (EMS) may contribute to this variation. A comprehensive overview of the different types of FR-systems used across Europe is lacking.

Methods: A mixed-method survey and information retrieved from national resuscitation councils and national EMS services were used as a basis for an inventory. The survey was sent to 51 OHCA experts across 29 European countries.

Results: Forty-seven (92%) OHCA experts from 29 countries responded to the survey. More than half of European countries had at least one region with a FR-system. Four categories of FR types were identified: (1) firefighters (professional/voluntary); (2) police officers; (3) citizen-responders; (4) others including off-duty EMS personnel (nurses, medical doctors), taxi drivers. Three main roles for FRs were identified: (a) complementary to EMS; (b) part of EMS; (c) instead of EMS. A wide variation in FR-systems was observed, both between and within countries.

Conclusions: Policies relating to FRs are commonly implemented on a regional level, leading to a wide variation in FR-systems between and within countries. Future research should focus on identifying the FR-systems that most strongly influence survival. The large variation in local circumstances across regions suggests that it is unlikely that there will be a 'one-size fits all' FR-system for Europe, but examining the role of FRs in the Chain of Survival is likely to become an increasingly important aspect of OHCA research.

Keywords: Cardiopulmonary resuscitation; ESCAPE-NET; Europe; First responders; Out-of-hospital cardiac arrest.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
First responders per type and European region. a, fire fighters. b, citizen-responders. c, police officers
Fig. 2
Fig. 2
Overview of first responder systems in Europe. a, overview of different types of dispatched first responder systems dispatched in the event of an out-of-hospital cardiac arrest, in Europe. The number of first responder refers to the number of first responders dispatched complementary to the statutory Emergency Medical Services. b, overview of regions/countries without dispatch of first responders after an out-of-hospital cardiac arrest, in Europe. Abbreviations: FRs, First responders, EMS, Emergency Medical Services
See this image and copyright information in PMC

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