Smartphone Activation of Citizen Responders to Facilitate Defibrillation in Out-of-Hospital Cardiac Arrest

Linn Andelius; Carolina Malta Hansen; Freddy K Lippert; Lena Karlsson; Christian Torp-Pedersen; Annette Kjær Ersbøll; Lars Køber; Helle Collatz Christensen; Stig Nikolaj Blomberg; Gunnar H Gislason; Fredrik Folke

doi:10.1016/j.jacc.2020.04.073

Smartphone Activation of Citizen Responders to Facilitate Defibrillation in Out-of-Hospital Cardiac Arrest

Linn Andelius, Carolina Malta Hansen, Freddy K Lippert, Lena Karlsson, Christian Torp-Pedersen, Annette Kjær Ersbøll, Lars Køber, Helle Collatz Christensen, Stig Nikolaj Blomberg, Gunnar H Gislason, Fredrik Folke

Research output: Contribution to journal › Journal article › Research › peer-review

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Abstract

BACKGROUND: Dispatching citizen responders through a smartphone application (app) holds the potential to increase bystander cardiopulmonary resuscitation (CPR) and defibrillation in out-of-hospital cardiac arrest (OHCA).

OBJECTIVES: This study investigated arrival at the OHCA location of app-dispatched citizen responders before the Emergency Medical Services (EMS) and the association with bystander CPR and bystander defibrillation.

METHODS: Suspected OHCAs with alerted citizen responders from September 1, 2017, to August 31, 2018, were included. Citizen responders located 1.8 km (1.1 miles) from the OHCA were dispatched to start CPR or retrieve an automated external defibrillator. OHCAs where at least 1 citizen responder arrived before EMS were compared with OHCAs where EMS arrived first. In both groups, random bystanders could be present before the arrival of citizen responders and the EMS. Primary outcomes were bystander CPR and bystander defibrillation, which included CPR and defibrillation by citizen responders and random bystanders.

RESULTS: Citizen responders were alerted in 819 suspected OHCAs, of which 438 (53.5%) were confirmed cardiac arrests eligible for inclusion. At least 1 citizen responder arrived before EMS in 42.0% (n = 184) of all included OHCAs. When citizen responders arrived before EMS, the odds for bystander CPR increased (odds ratio: 1.76; 95% confidence interval: 1.07 to 2.91; p = 0.027) and the odds for bystander defibrillation more than tripled (odds ratio: 3.73; 95% confidence interval: 2.04 to 6.84; p < 0.001) compared with OHCAs in which citizen responders arrived after EMS.

CONCLUSIONS: Arrival of app-dispatched citizen responders before EMS was associated with increased odds for bystander CPR and a more than 3-fold increase in odds for bystander defibrillation. (The HeartRunner Trial; NCT03835403).

Original language	English
Journal	Journal of the American College of Cardiology
Volume	76
Issue number	1
Pages (from-to)	43-53
Number of pages	11
ISSN	0735-1097
DOIs	https://doi.org/10.1016/j.jacc.2020.04.073
Publication status	Published - 7 Jul 2020

Bibliographical note

Keywords

AED
OHCA
cardiopulmonary resuscitation
citizen responder
smartphone app
volunteer

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Andelius, L., Malta Hansen, C., Lippert, F. K., Karlsson, L., Torp-Pedersen, C., Kjær Ersbøll, A., Køber, L., Collatz Christensen, H., Blomberg, S. N., Gislason, G. H., & Folke, F. (2020). Smartphone Activation of Citizen Responders to Facilitate Defibrillation in Out-of-Hospital Cardiac Arrest. Journal of the American College of Cardiology, 76(1), 43-53. https://doi.org/10.1016/j.jacc.2020.04.073

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title = "Smartphone Activation of Citizen Responders to Facilitate Defibrillation in Out-of-Hospital Cardiac Arrest",

abstract = "BACKGROUND: Dispatching citizen responders through a smartphone application (app) holds the potential to increase bystander cardiopulmonary resuscitation (CPR) and defibrillation in out-of-hospital cardiac arrest (OHCA).OBJECTIVES: This study investigated arrival at the OHCA location of app-dispatched citizen responders before the Emergency Medical Services (EMS) and the association with bystander CPR and bystander defibrillation.METHODS: Suspected OHCAs with alerted citizen responders from September 1, 2017, to August 31, 2018, were included. Citizen responders located 1.8 km (1.1 miles) from the OHCA were dispatched to start CPR or retrieve an automated external defibrillator. OHCAs where at least 1 citizen responder arrived before EMS were compared with OHCAs where EMS arrived first. In both groups, random bystanders could be present before the arrival of citizen responders and the EMS. Primary outcomes were bystander CPR and bystander defibrillation, which included CPR and defibrillation by citizen responders and random bystanders.RESULTS: Citizen responders were alerted in 819 suspected OHCAs, of which 438 (53.5%) were confirmed cardiac arrests eligible for inclusion. At least 1 citizen responder arrived before EMS in 42.0% (n = 184) of all included OHCAs. When citizen responders arrived before EMS, the odds for bystander CPR increased (odds ratio: 1.76; 95% confidence interval: 1.07 to 2.91; p = 0.027) and the odds for bystander defibrillation more than tripled (odds ratio: 3.73; 95% confidence interval: 2.04 to 6.84; p < 0.001) compared with OHCAs in which citizen responders arrived after EMS.CONCLUSIONS: Arrival of app-dispatched citizen responders before EMS was associated with increased odds for bystander CPR and a more than 3-fold increase in odds for bystander defibrillation. (The HeartRunner Trial; NCT03835403).",

keywords = "AED, OHCA, cardiopulmonary resuscitation, citizen responder, smartphone app, volunteer",

author = "Linn Andelius and {Malta Hansen}, Carolina and Lippert, {Freddy K} and Lena Karlsson and Christian Torp-Pedersen and {Kj{\ae}r Ersb{\o}ll}, Annette and Lars K{\o}ber and {Collatz Christensen}, Helle and Blomberg, {Stig Nikolaj} and Gislason, {Gunnar H} and Fredrik Folke",

year = "2020",

month = jul,

day = "7",

doi = "10.1016/j.jacc.2020.04.073",

language = "English",

volume = "76",

pages = "43--53",

journal = "Journal of the American College of Cardiology",

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Andelius, L, Malta Hansen, C, Lippert, FK, Karlsson, L, Torp-Pedersen, C, Kjær Ersbøll, A, Køber, L, Collatz Christensen, H, Blomberg, SN, Gislason, GH & Folke, F 2020, 'Smartphone Activation of Citizen Responders to Facilitate Defibrillation in Out-of-Hospital Cardiac Arrest', Journal of the American College of Cardiology, vol. 76, no. 1, pp. 43-53. https://doi.org/10.1016/j.jacc.2020.04.073

TY - JOUR

T1 - Smartphone Activation of Citizen Responders to Facilitate Defibrillation in Out-of-Hospital Cardiac Arrest

AU - Andelius, Linn

AU - Malta Hansen, Carolina

AU - Lippert, Freddy K

AU - Karlsson, Lena

AU - Torp-Pedersen, Christian

AU - Kjær Ersbøll, Annette

AU - Køber, Lars

AU - Collatz Christensen, Helle

AU - Blomberg, Stig Nikolaj

AU - Gislason, Gunnar H

AU - Folke, Fredrik

PY - 2020/7/7

Y1 - 2020/7/7

N2 - BACKGROUND: Dispatching citizen responders through a smartphone application (app) holds the potential to increase bystander cardiopulmonary resuscitation (CPR) and defibrillation in out-of-hospital cardiac arrest (OHCA).OBJECTIVES: This study investigated arrival at the OHCA location of app-dispatched citizen responders before the Emergency Medical Services (EMS) and the association with bystander CPR and bystander defibrillation.METHODS: Suspected OHCAs with alerted citizen responders from September 1, 2017, to August 31, 2018, were included. Citizen responders located 1.8 km (1.1 miles) from the OHCA were dispatched to start CPR or retrieve an automated external defibrillator. OHCAs where at least 1 citizen responder arrived before EMS were compared with OHCAs where EMS arrived first. In both groups, random bystanders could be present before the arrival of citizen responders and the EMS. Primary outcomes were bystander CPR and bystander defibrillation, which included CPR and defibrillation by citizen responders and random bystanders.RESULTS: Citizen responders were alerted in 819 suspected OHCAs, of which 438 (53.5%) were confirmed cardiac arrests eligible for inclusion. At least 1 citizen responder arrived before EMS in 42.0% (n = 184) of all included OHCAs. When citizen responders arrived before EMS, the odds for bystander CPR increased (odds ratio: 1.76; 95% confidence interval: 1.07 to 2.91; p = 0.027) and the odds for bystander defibrillation more than tripled (odds ratio: 3.73; 95% confidence interval: 2.04 to 6.84; p < 0.001) compared with OHCAs in which citizen responders arrived after EMS.CONCLUSIONS: Arrival of app-dispatched citizen responders before EMS was associated with increased odds for bystander CPR and a more than 3-fold increase in odds for bystander defibrillation. (The HeartRunner Trial; NCT03835403).

AB - BACKGROUND: Dispatching citizen responders through a smartphone application (app) holds the potential to increase bystander cardiopulmonary resuscitation (CPR) and defibrillation in out-of-hospital cardiac arrest (OHCA).OBJECTIVES: This study investigated arrival at the OHCA location of app-dispatched citizen responders before the Emergency Medical Services (EMS) and the association with bystander CPR and bystander defibrillation.METHODS: Suspected OHCAs with alerted citizen responders from September 1, 2017, to August 31, 2018, were included. Citizen responders located 1.8 km (1.1 miles) from the OHCA were dispatched to start CPR or retrieve an automated external defibrillator. OHCAs where at least 1 citizen responder arrived before EMS were compared with OHCAs where EMS arrived first. In both groups, random bystanders could be present before the arrival of citizen responders and the EMS. Primary outcomes were bystander CPR and bystander defibrillation, which included CPR and defibrillation by citizen responders and random bystanders.RESULTS: Citizen responders were alerted in 819 suspected OHCAs, of which 438 (53.5%) were confirmed cardiac arrests eligible for inclusion. At least 1 citizen responder arrived before EMS in 42.0% (n = 184) of all included OHCAs. When citizen responders arrived before EMS, the odds for bystander CPR increased (odds ratio: 1.76; 95% confidence interval: 1.07 to 2.91; p = 0.027) and the odds for bystander defibrillation more than tripled (odds ratio: 3.73; 95% confidence interval: 2.04 to 6.84; p < 0.001) compared with OHCAs in which citizen responders arrived after EMS.CONCLUSIONS: Arrival of app-dispatched citizen responders before EMS was associated with increased odds for bystander CPR and a more than 3-fold increase in odds for bystander defibrillation. (The HeartRunner Trial; NCT03835403).

KW - AED

KW - OHCA

KW - cardiopulmonary resuscitation

KW - citizen responder

KW - smartphone app

KW - volunteer

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DO - 10.1016/j.jacc.2020.04.073

M3 - Journal article

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JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

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Smartphone Activation of Citizen Responders to Facilitate Defibrillation in Out-of-Hospital Cardiac Arrest

Abstract

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