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. 2020 Jul:152:16-25.
doi: 10.1016/j.resuscitation.2020.05.006. Epub 2020 May 11.

Enhancing citizens response to out-of-hospital cardiac arrest: A systematic review of mobile-phone systems to alert citizens as first responders

Tommaso Scquizzato  1 , Ottavia Pallanch  2 , Alessandro Belletti  2 , Antonio Frontera  3 , Luca Cabrini  4 , Alberto Zangrillo  5 , Giovanni Landoni  5
Affiliations

Enhancing citizens response to out-of-hospital cardiac arrest: A systematic review of mobile-phone systems to alert citizens as first responders

Tommaso Scquizzato et al. Resuscitation. 2020 Jul.

Abstract

Introduction: Involving laypersons in response to out-of-hospital cardiac arrest through mobile-phone technology is becoming widespread in numerous countries, and different solutions were developed. We performed a systematic review on the impact of alerting citizens as first responders and to provide an overview of different strategies and technologies used.

Methods: We searched electronic databases up to October 2019. Eligible studies described systems to alert citizens first responders to out-of-hospital cardiac arrest through text messages or apps. We analyzed the implementation and performance of these systems and their impact on patients' outcomes.

Results: We included 28 manuscripts describing 12 different systems. The first text message system was implemented in 2006 and the first app in 2010. First responders accepted to intervene in median (interquartile) 28.7% (27-29%) of alerts and reached the scene after 4.6 (4.4-5.5) minutes for performing CPR. First responders arrived before ambulance, started CPR and attached a defibrillator in 47% (34-58%), 24% (23-27%) and 9% (6-14%) of cases, respectively. Pooled analysis showed that first responders activation increased layperson-CPR rates (1463/2292 [63.8%] in the intervention group vs. 1094/1989 [55.0%] in the control group; OR = 1.70; 95% CI, 1.11-2.60; p = 0.01) and survival to hospital discharge or at 30 days (327/2273 [14.4%] vs. 184/1955 [9.4%]; OR = 1.51; 95% CI, 1.24-1.84; p < 0.001).

Conclusions: Alerting citizens as first responders in case of out-of-hospital cardiac arrest may reduce the intervention-free time and improve patients' outcomes.

Keywords: Cardiopulmonary resuscitation; First responders; Mobile-phone technology; Out-of-hospital cardiac arrest.

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Figures

Fig. 1
Fig. 1
Selection of included studies.
Fig. 2
Fig. 2
Forest plots for rate of bystander-CPR (A), survival to discharge or 30 days (B), and return of spontaneous circulation (C). df = degrees of freedom, M-H = Mantel–Haenszel.
Fig. 3
Fig. 3
Strategy, technology and patients’ outcomes: the three dimensions of systems to locate and alert citizens first responders to nearby out-of-hospital cardiac arrests.
See this image and copyright information in PMC

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