Mobile phone-based alerting of CPR-trained volunteers simultaneously with the ambulance can reduce the resuscitation-free interval and improve outcome after out-of-hospital cardiac arrest: A German, population-based cohort study.

Stroop, Ralf; Kerner, Thoralf; Strickmann, Bernd; Hensel, Mario

doi:10.1016/j.resuscitation.2019.12.012

Cardiac arrest & resuscitation

Mobile phone-based alerting of CPR-trained volunteers simultaneously with the ambulance can reduce the resuscitation-free interval and improve outcome after out-of-hospital cardiac arrest: A German, population-based cohort study.

Ralf Stroop, Thoralf Kerner, Bernd Strickmann, Mario Hensel

Resuscitation · 2019-12-27 · Observational study

Read at publisher · PubMed

Abstract

AIM: To test the hypothesis that simultaneous mobile phone-based alerting of CPR-trained volunteers (Mobile-Rescuers) with Emergency Medical Service (EMS) teams leads to better outcomes in out-of-hospital cardiac arrest (OHCA) victims than EMS alerting alone. METHODS: The outcomes of 730 OHCA patients were retrospectively analysed, depending on who initiated CPR: Mobile-Rescuer-initiated-CPR (n = 94), EMS-initiated-CPR (n = 359), lay bystander-initiated-CPR (n = 277). An adjusted analysis of the intervention and their main outcomes (emergency response time, return of spontaneous circulation, hospital discharge rate, neurological outcomes) was performed (Propensity Score Method with patient matching). RESULTS: Recruited and trained Mobile-Rescuers (n = 740) arrived at the scene in 46% of all triggered alarms. There was a significant difference in response time between Mobile-Rescuers (4 min) and EMS teams (7 min), (p < 0.001). Compared to EMS-initiated-CPR, Mobile-Rescuer-initiated-CPR patients more frequently showed a return of spontaneous circulation, but statistical significance was narrowly missed (p = 0.056). The hospital discharge rate was significantly higher with the Mobile-Rescuer (18%) vs. EMS (7%), (p = 0.049). Good neurological outcomes (Cerebral Performance Categories Score 1 and 2) were seen in 11% of Mobile-Rescuer patients and 4% of EMS patients (p = 0.165). There were no significant differences compared with lay bystander-initiated-CPR. CONCLUSION: Simultaneous alerting of nearby CPR-trained volunteers complementary to professional EMS teams can reduce both the response time and resuscitation-free interval and might improve hospital discharge rate and neurological outcomes after OHCA.

Mobile phone-based alerting of CPR-trained volunteers simultaneously with the ambulance can reduce the resuscitation-free interval and improve outcome after out-of-hospital cardiac arrest: A German, population-based cohort study.

Abstract

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