Aims Automated external defibrillators (AEDs) are placed in public, but the majority of out-of-hospital cardiac arrests (OHCA) occur at home. Methods and results In residential areas, 785 AEDs were placed and 5735 volunteer responders were recruited. For suspected OHCA, dispatchers activated nearby volunteer responders with text messages, directing two-thirds to an AED first and one-third directly to the patient. We analysed survival (primary outcome) and neurologically favourable survival to discharge, time to first defibrillation shock, and cardiopulmonary resuscitation (CPR) before Emergency Medical Service (EMS) arrival of patients in residences found with ventricular fibrillation (VF), before and after introduction of this text-message alert system. Survival from OHCAs in residences increased from 26% to 39% {adjusted relative risk (RR) 1.5 [95% confidence interval (CI): 1.03–2.0]}. RR for neurologically favourable survival was 1.4 (95% CI: 0.99–2.0). No CPR before ambulance arrival decreased from 22% to 9% (RR: 0.5, 95% CI: 0.3–0.7). Text-message-responders with AED administered shocks to 16% of all patients in VF in residences, while defibrillation by EMS decreased from 73% to 39% in residences (P < 0.001). Defibrillation by first responders in residences increased from 22 to 40% (P < 0.001). Use of public AEDs in residences remained unchanged (6% and 5%) (P = 0.81). Time from emergency call to defibrillation decreased from median 11.7 to 9.3 min; mean difference –2.6 (95% CI: –3.5 to –1.6). Conclusion Introducing volunteer responders directed to AEDs, dispatched by text-message was associated with significantly reduced time to first defibrillation, increased bystander CPR and increased overall survival for OHCA patients in residences found with VF. Key Question The Emergency Medical Service introduced a text-message alert system to alert volunteers close to an out-of-hospital cardiac arrest patient. In addition, 785 automated external defibrillators (AEDs) were added and made available in the community. Does adding this system result in more basic life support (BLS), earlier defibrillation, and better survival? Key Finding We found that BLS increased from 78% to 91%, the time from emergency call to the first defibrillation shock decreased by 2.6 min and survival for patients at home, and found in ventricular fibrillation, increased from 26% to 39%. Take Home Message For patients with a cardiac arrest at home, an alert system that includes nearby volunteers activated by the ambulance dispatch centre and many easily accessible AEDs really saves lives. Implementation is an effective community effort.

中文翻译：

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在家中为心脏骤停提供警报系统支持的非专业除颤和基本生命支持

目标 自动体外除颤器 (AED) 被放置在公共场所，但大多数院外心脏骤停 (OHCA) 发生在家中。方法与结果 在居民区，放置 AED 785 台，招募志愿者 5735 名。对于疑似 OHCA，调度员会通过短信激活附近的志愿者响应者，将三分之二的人先引导至 AED，将三分之一的人直接引导至患者。我们分析了心室颤动 (VF) 患者在紧急医疗服务 (EMS) 到达之前、引入之前和之后的生存率（主要结果）和神经系统有利的出院生存率、首次除颤电击时间和心肺复苏 (CPR)这个短信警报系统。居住中 OHCA 的存活率从 26% 增加到 39% {调整后的相对风险 (RR) 1. 5 [95% 置信区间 (CI)：1.03–2.0]}。神经系统有利生存的 RR 为 1.4（95% CI：0.99-2.0）。救护车到达前未进行 CPR 从 22% 降至 9%（RR：0.5，95% CI：0.3-0.7）。带有 AED 的短信应答器对住宅中 16% 的 VF 患者进行了电击，而在住宅中通过 EMS 进行除颤的比例从 73% 降至 39% (P < 0.001)。住所中急救人员的除颤从 22% 增加到 40% (P < 0.001)。住宅中公共 AED 的使用保持不变（6% 和 5%）（P = 0.81）。从紧急呼叫到除颤的时间从中位数 11.7 分钟减少到 9.3 分钟；平均差 –2.6（95% CI：–3.5 至 –1.6）。结 增加旁观者心肺复苏术和增加 OHCA 患者在发现有 VF 的住宅中的总生存期。关键问题 紧急医疗服务引入了短信警报系统，以提醒接近院外心脏骤停患者的志愿者。此外，还增加了 785 台自动体外除颤器 (AED)，并在社区中提供。添加该系统是否会带来更多的基本生命支持 (BLS)、更早的除颤和更好的生存？关键发现 我们发现，BLS 从 78% 增加到 91%，从紧急呼叫到第一次除颤电击的时间减少了 2.6 分钟，在家中发现心室颤动的患者的存活率从 26% 增加到 39%。带回家的信息对于在家中发生心脏骤停的患者，由救护车调度中心激活的附近志愿者和许多易于使用的 AED 组成的警报系统确实可以挽救生命。实施是一项有效的社区努力。