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. 2023 Feb 9;12(2):87-95.
doi: 10.1093/ehjacc/zuac165.

Smartphone-activated volunteer responders and bystander defibrillation for out-of-hospital cardiac arrest in private homes and public locations

Linn Andelius  1   2 , Carolina Malta Hansen  1   3 , Martin Jonsson  4 , Thomas A Gerds  5   6 , Shahzleen Rajan  7 , Christian Torp-Pedersen  8   9 , Andreas Claesson  4 , Freddy Lippert  1 , Mads Chr Tofte Gregers  1   2 , Ellinor Berglund  4 , Gunnar H Gislason  5   7 , Lars Køber  3 , Jacob Hollenberg  4 , Mattias Ringh  4 , Fredrik Folke  1   2   7
Affiliations

Smartphone-activated volunteer responders and bystander defibrillation for out-of-hospital cardiac arrest in private homes and public locations

Linn Andelius et al. Eur Heart J Acute Cardiovasc Care. .

Abstract

Aims: To investigate the association between the arrival of smartphone-activated volunteer responders before the Emergency Medical Services (EMS) and bystander defibrillation in out-of-hospital cardiac arrest (OHCA) at home and public locations.

Methods and results: This is a retrospective study (1 September 2017-14 May 2019) from the Stockholm Region of Sweden and the Capital Region of Denmark. We included 1271 OHCAs, of which 1029 (81.0%) occurred in private homes and 242 (19.0%) in public locations. The main outcome was bystander defibrillation. At least one volunteer responder arrived before EMS in 381 (37.0%) of OHCAs at home and 84 (34.7%) in public. More patients received bystander defibrillation when a volunteer responder arrived before EMS at home (15.5 vs. 2.2%, P < 0.001) and in public locations (32.1 vs. 19.6%, P = 0.030). Similar results were found among the 361 patients with an initial shockable heart rhythm (52.7 vs. 11.5%, P < 0.001 at home and 60.0 vs. 37.8%, P = 0.025 in public). The standardized probability of receiving bystander defibrillation increased with longer EMS response times in private homes. The 30-day survival was not significantly higher when volunteer responders arrived before EMS (9.2 vs. 7.7% in private homes, P = 0.41; and 40.5 vs. 35.4% in public locations, P = 0.44).

Conclusion: Bystander defibrillation was significantly more common in private homes and public locations when a volunteer responder arrived before the EMS. The standardized probability of bystander defibrillation increased with longer EMS response times in private homes. Our findings support the activation of volunteer responders and suggest that volunteer responders could increase bystander defibrillation, particularly in private homes.

Keywords: AED; CPR; OHCA; dispatch; responder app.

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Conflict of interest statement

Conflict of interest: L.A., C.M.H., M.C.T.G., and F.F. have received research grants from TrygFonden. C.M.H. has received research grants from Laerdal Foundation and Helsefonden. F.F. has received research grants from the Novo Nordisk Foundation and the Laerdal Foundation. L.K. has received speaker honoraria from AstraZeneca, Novo Nordisk, Boehringer, and Novartis. C.T.-P. has received research grants from Bayer and Novo Nordisk. A.C., J.H., and M.R. are shareholders in the HeartRunner app. Other authors have no disclosures to declare.

Figures

Graphical Abstract
Graphical Abstract
Figure 1
Figure 1
Flowchart illustrating patient selection. EMS, Emergency Medical Services; OHCA, out-of-hospital cardiac arrest.
Figure 2
Figure 2
Chances of at least one volunteer responder arriving before EMS according to the location of out-of-hospital cardiac arrest. EMS, Emergency Medical Services; OHCA, out-of-hospital cardiac arrest.
Figure 3
Figure 3
Standardized chances of bystander defibrillation according to the location of out-of-hospital cardiac arrest. EMS, Emergency Medical Services; OHCA, out-of-hospital cardiac arrest.
See this image and copyright information in PMC

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