Defining the terminology of first responders alerted for out-of-hospital cardiac arrest by medical dispatch centres: An international consensus study on nomenclature

Camilla Metelmann¹, Bibiana Metelmann¹, Michael P Müller², Tommaso Scquizzato³, Enrico Baldi^{4

5}, Tomas Barry⁶, Bernd W Böttiger^{7

8}, Hans-Jörg Busch⁹, Maria Luce Caputo^{10

11}, Sheldon Cheskes¹², Ruggero Cresta^{11

13}, Charles D Deakin¹⁴, Eva Degraeuwe¹⁵, Ankur A Doshi¹⁶, Mette M Ekkel¹⁷, Daniel Elschenbroich¹⁸, David Fredman¹⁹, Lorenzo Gamberini²⁰, Julian Ganter²¹, Finn L Henriksen²², Caroline Jagtenberg²³, Martin Jonsson²⁴, Michael Khalemsky²⁵, Tom A Kooy²⁶, Carsten Lott²⁷, Tore Marks¹, Koen G Monsieurs²⁸, Esther Moens²⁹, Wei Ming Ng³⁰, Jan-Steffen Pooth⁹, Stefan Prasse³¹, David D Salcido³², Andrea Scapigliati^{33

34}, Nadja Schittko³⁵, Sebastian Schnaubelt^{36

37}, Sean S Scholz³⁸, Persia Shahriari³⁹, Paul Snobelen⁴⁰, Remy Stieglis¹⁷, Bernd Strickmann⁴¹, Hanno L Tan^{42

43}, Karl C Thies³⁸, Steven Vercammen⁴⁴, Wolfgang A Wetsch^{7

8}, Robert Greif^{45

46}

Affiliations

¹ Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Medicine Greifswald, Greifswald, Germany.
² Department of Anaesthesiology, Intensive Care, and Emergency Medicine, St. Josefs Hospital Freiburg, Freiburg, Germany.
³ Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
⁴ Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
⁵ Cardiac Arrest and Resuscitation Science Research Team (RESTART), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
⁶ UCD School of Medicine, University College Dublin, Ireland.
⁷ Department of Anaesthesiology and Intensive Care Medicine, Medical Faculty and University Hospital of Cologne, Cologne, Germany.
⁸ German Resuscitation Council (GRC), Ulm and Cologne, Germany.
⁹ Department of Emergency Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
¹⁰ Cardiocentro Ticino Institute-Ente Ospedaliero Cantonale, Lugano, Switzerland.
¹¹ Ticino Cuore Foundation, Lugano, Switzerland.
¹² Department of Family and Community Medicine, Division of Emergency Medicine, University of Toronto, Canada.
¹³ Ticino Canton EMS Federation, Bellinzona, Switzerland.
¹⁴ University Hospital Southampton, Southampton UK & South Central Ambulance Service, Otterbourne, UK.
¹⁵ Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.
¹⁶ University of Pittsburgh School of Medicine, PA, United States.
¹⁷ Amsterdam UMC Location University of Amsterdam, Anesthesiology, Amsterdam, the Netherlands.
¹⁸ Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
¹⁹ Heartrunner Citizen Responder System, Heartrunner Sweden AB, Solna, Sweden.
²⁰ Emergency Department, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy.
²¹ Department of Anaesthesiology and Critical Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
²² Department of Cardiology, Odense University Hospital, Denmark.
²³ Vrije Universiteit Amsterdam, School of Business and Economics, Amsterdam, the Netherlands.
²⁴ Center for Resuscitation Science, Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
²⁵ Department of Management, Hadassah Academic College, Jerusalem, Israel.
²⁶ Stan, Citizen Responder Network HartslagNu, Netherlands.
²⁷ Ärztlicher Leiter Rettungsdienst, Rettungsdienstbereich Mainz, Germany.
²⁸ Department of Emergency Medicine, Antwerp University Hospital and University of Antwerp, Edegem, Belgium.
²⁹ Ghent University, Ghent, Belgium.
³⁰ Department of Emergency Medicine, Ng Teng Fong General Hospital, Singapore.
³¹ Mobile Retter e.V, Köln, Germany.
³² University of Pittsburgh, Department of Emergency Medicine, Pittsburgh, PA, United States of America.
³³ Cardiac Anesthesia and Postoperative ICU, Fondazione Policlinico A.Gemelli, IRCCS. Institute of Anesthesia and Intensive Care, Catholic University of the Sacred Heart, Rome, Italy.
³⁴ Italian Resuscitation Council, Italy.
³⁵ ADAC Stiftung, München, Germany.
³⁶ Emergency Medical Service Vienna, Austria.
³⁷ Dpt. of Emergency Medicine, Medical University of Vienna, Austria.
³⁸ Department of Anaesthesiology, Intensive Care, Emergency Medicine, Transfusion Medicine and Pain Therapy, University Hospital of Bielefeld, Campus Bielefeld-Bethel, University of Bielefeld, Bielefeld, Germany.
³⁹ Emergency Medical Services, Capital Region of Denmark, Ballerup, Copenhagen, Denmark.
⁴⁰ Peel Regional Paramedic Services, Ontario, Canada.
⁴¹ Emergency Medical Service, District of Gütersloh (Kreis Gütersloh), Germany.
⁴² Department of Cinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
⁴³ Netherlands Heart Institute, Utrecht, the Netherlands.
⁴⁴ EVapp NGO, Belgium.
⁴⁵ Faculty of Medicine, University of Bern, Bern, Switzerland.
⁴⁶ Department of Surgical Sciences, University of Turin, Turin, Italy.

PMID: 40123987
PMCID: PMC11929050
DOI: 10.1016/j.resplu.2025.100912

Defining the terminology of first responders alerted for out-of-hospital cardiac arrest by medical dispatch centres: An international consensus study on nomenclature

Camilla Metelmann et al. Resusc Plus. 2025.

. 2025 Feb 20:22:100912.

doi: 10.1016/j.resplu.2025.100912. eCollection 2025 Mar.

Authors

Affiliations

¹ Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Medicine Greifswald, Greifswald, Germany.
² Department of Anaesthesiology, Intensive Care, and Emergency Medicine, St. Josefs Hospital Freiburg, Freiburg, Germany.
³ Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
⁴ Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
⁵ Cardiac Arrest and Resuscitation Science Research Team (RESTART), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
⁶ UCD School of Medicine, University College Dublin, Ireland.
⁷ Department of Anaesthesiology and Intensive Care Medicine, Medical Faculty and University Hospital of Cologne, Cologne, Germany.
⁸ German Resuscitation Council (GRC), Ulm and Cologne, Germany.
⁹ Department of Emergency Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
¹⁰ Cardiocentro Ticino Institute-Ente Ospedaliero Cantonale, Lugano, Switzerland.
¹¹ Ticino Cuore Foundation, Lugano, Switzerland.
¹² Department of Family and Community Medicine, Division of Emergency Medicine, University of Toronto, Canada.
¹³ Ticino Canton EMS Federation, Bellinzona, Switzerland.
¹⁴ University Hospital Southampton, Southampton UK & South Central Ambulance Service, Otterbourne, UK.
¹⁵ Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.
¹⁶ University of Pittsburgh School of Medicine, PA, United States.
¹⁷ Amsterdam UMC Location University of Amsterdam, Anesthesiology, Amsterdam, the Netherlands.
¹⁸ Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
¹⁹ Heartrunner Citizen Responder System, Heartrunner Sweden AB, Solna, Sweden.
²⁰ Emergency Department, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy.
²¹ Department of Anaesthesiology and Critical Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
²² Department of Cardiology, Odense University Hospital, Denmark.
²³ Vrije Universiteit Amsterdam, School of Business and Economics, Amsterdam, the Netherlands.
²⁴ Center for Resuscitation Science, Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
²⁵ Department of Management, Hadassah Academic College, Jerusalem, Israel.
²⁶ Stan, Citizen Responder Network HartslagNu, Netherlands.
²⁷ Ärztlicher Leiter Rettungsdienst, Rettungsdienstbereich Mainz, Germany.
²⁸ Department of Emergency Medicine, Antwerp University Hospital and University of Antwerp, Edegem, Belgium.
²⁹ Ghent University, Ghent, Belgium.
³⁰ Department of Emergency Medicine, Ng Teng Fong General Hospital, Singapore.
³¹ Mobile Retter e.V, Köln, Germany.
³² University of Pittsburgh, Department of Emergency Medicine, Pittsburgh, PA, United States of America.
³³ Cardiac Anesthesia and Postoperative ICU, Fondazione Policlinico A.Gemelli, IRCCS. Institute of Anesthesia and Intensive Care, Catholic University of the Sacred Heart, Rome, Italy.
³⁴ Italian Resuscitation Council, Italy.
³⁵ ADAC Stiftung, München, Germany.
³⁶ Emergency Medical Service Vienna, Austria.
³⁷ Dpt. of Emergency Medicine, Medical University of Vienna, Austria.
³⁸ Department of Anaesthesiology, Intensive Care, Emergency Medicine, Transfusion Medicine and Pain Therapy, University Hospital of Bielefeld, Campus Bielefeld-Bethel, University of Bielefeld, Bielefeld, Germany.
³⁹ Emergency Medical Services, Capital Region of Denmark, Ballerup, Copenhagen, Denmark.
⁴⁰ Peel Regional Paramedic Services, Ontario, Canada.
⁴¹ Emergency Medical Service, District of Gütersloh (Kreis Gütersloh), Germany.
⁴² Department of Cinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
⁴³ Netherlands Heart Institute, Utrecht, the Netherlands.
⁴⁴ EVapp NGO, Belgium.
⁴⁵ Faculty of Medicine, University of Bern, Bern, Switzerland.
⁴⁶ Department of Surgical Sciences, University of Turin, Turin, Italy.

PMID: 40123987
PMCID: PMC11929050
DOI: 10.1016/j.resplu.2025.100912

Abstract

Aim: Emergency medical services target to reduce time to cardiopulmonary resuscitation and defibrillation by alerting additional individuals to out-of-hospital cardiac arrest (OHCA). Multiple terms are used to describe these individuals, potentially causing confusion and hindering comparisons. This international consensus study aimed to establish standardised terminology.

Methods: Forty-six interdisciplinary researchers from four continents participated in a symposium on "Community First Responders" with the objective of standardising relevant terminology. Initially, terms were proposed anonymously for individuals alerted during work hours and those alerted during leisure time. Each term was rated on a 5-point Likert scale. Terms receiving a high level of agreement were included in the final voting process.

Results: Seven terms were suggested for individuals alerted during work hours. In the first voting "first responder", "professional first responder", and "on-duty first responder" achieved high agreement. Ultimately, consensus was reached on the term "on-duty first responder".For individuals alerted during leisure time, ten terms were proposed. Among these, "first responder", "citizen first responder", "community emergency responder", "community first responder", "volunteer first responder", "volunteer responder", and "volunteer community first responder" reached high agreement. In the final vote "community first responder" was selected.The consensus group agreed that the overarching term "first responder" should be used to describe all community-based individuals, who are alerted, regardless of whether they are on duty or off duty.

Conclusion: This consensus study recommends using the terms "on-duty first responder" and "community first responder" to describe individuals additionally alerted by medical dispatch centres to facilitate early intervention in OHCA.

Keywords: Community first responder; OHCA; On-duty First Responder; Systems Saving Lives; Volunteer First Responder.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: “MPM is chair of Region of Lifesavers non-profit organisation, shareholder of SmartResQ Aps, and member of the executive committee of the German Resuscitation Council (GRC). EB is member of the ERC Research-NET and of the ESCAPE-NET consortium and is working group leader of the COST Action PARQ (grant agreement No CA19137) supported by COST (European Cooperation in Science and Technology). BWB is treasurer of the European Resuscitation Council (ERC), Founder of the ERC Research NET, Chairman of the German Resuscitation Council (GRC), Member of the „Advanced Life Support (ALS) Task Force of the International Liaison Committee on Resuscitation (ILCOR), Former Member of the Executive Committee of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI), Founder of the “Deutsche Stiftung Wiederbelebung”, Federal Medical Advisor of the German Red Cross (DRK), Member of the Advisory Board of the “Deutsche Herzstiftung”, Co-Editor of “Resuscitation”, Editor of the Journal “Notfall + Rettungsmedizin”, Co-Editor of the Brazilian Journal of Anesthesiology. BWB received fees for lectures from the following companies: Forum für medizinische Fortbildung (FomF), ZOLL Medical Deutschland GmbH, C.R. Bard GmbH, Becton Dickinson GmbH. HJB is vice-chair of Region of Lifesavers non-profit organisation and member of the German Resuscitation Council (GRC). SC is member of the Editorial Board of Resuscitation. CDD is member of the Editorial Board of Resuscitation. AAD received grant funding from the Hillman Family Foundation. DF is co-founder and operations manager of the Heartrunner Citizen Responder System, Sweden and member of the tech&ops committee of EENA (European Emergency Number Association). JG is board member of Region of Lifesavers. FLH is one of the partners who developed FirstAED smartphone technology for GPS tracking of first responders. MJ is a working group leader in the EU-funded network PARQ-COST, focusing on cardiac arrest research. KGM is the Chair of the European Resuscitation Council and is member of the Editorial Board of Resuscitation. TK is employed at STAN B.V., which manages the Dutch HartslagNu responder platform. CL is member of the Editorial Board of Resuscitation. JSP is part-time employee of Resuscitec GmbH, member of “Region der Lebensretter e.V.”, member of the executive committee of the German Resuscitation Council. JSP receives financial support from the German Heart Foundation (Deutsche Stiftung für Herzforschung) to coordinate the HEROES study (grant number F/02/23). SP works for Mobile Retter e.V.. AS is chair of IRC. PS received research grants from TrygFonden. TS is the Social Media Editor of Resuscitation and Resuscitation Plus. HLT is chair of the EU-COST Action PARQ (grant agreement No CA19137) supported by COST (European Cooperation in Science and Technology). SV is president of the Belgian EVapp NGO, who maintains the Belgian first responder network EVapp, and is shareholder of Prior-IT BV, who builds software systems related to first responders. RG is the ERC Director of Guidelines and ILCOR, the Task Force chair of Education, Implementation and Teams of ILCOR, and member of the editorial board of Resuscitation Plus. BM, CM, TB, MLC, ED, DE, ME, CJ, LG, MK, EM, TM, WMN, CR, DDS, NS, SS, PSn, SSS, RS, BS and WW have no conflict of interest to declare.”.

Figures

**Fig. 1**
Answers to the pre-symposium survey.

**Fig. 2**
Results of the first voting on proposed terms (a: during work hours and b: during leisure time). The grey line marks the cut-off for high agreement (“4” and “5” on Likert by ≥20% of the participants). The individual dark lines mark the aggregated voting of “4” and “5” on the Likert scale.

See this image and copyright information in PMC

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Defining the terminology of first responders alerted for out-of-hospital cardiac arrest by medical dispatch centres: An international consensus study on nomenclature

Affiliations

Defining the terminology of first responders alerted for out-of-hospital cardiac arrest by medical dispatch centres: An international consensus study on nomenclature

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

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