Background Community First Responders (CFRs) are volunteers dispatched by Emergency Medical Services (EMS) to potentially life-threatening emergencies to provide care until the ambulance staff arrive. Previous qualitative research described CFRs’ role, perceptions, and motivations, but quantitative evidence on their contribution to rural healthcare provision is lacking. We aimed to investigate the number, types, and location of calls (rural or urban), and characteristics of patients attended. Methods We used a retrospective observational design analysing routine data from six of ten ambulance services in England during 2019. Descriptive statistics were used to directly compare incidents where CFRs attended first with attendances from ambulance staff. A multiple logistic regression model was used to identify the main predictors of CFR attendance. Results The data included 4.5 million incidents over one year. CFRs attended first a significantly higher proportion of calls in rural areas compared to urban areas (3.90% vs 1.48%, p<0.05). The main predictors of CFR presence were rurality (Odds Ratio [OR] 2.05, 95% Confidence Interval [CI] 1.99-2.11, p<0.001), conditions including cardiorespiratory (OR 9.20, 95%CI 5.08-16.64, p<0.001) or neurological/endocrine (OR 9.26, 95%CI 5.12-16.77, p<0.001) and the most urgent call category 1 (OR 5.19, 95%CI 3.86-6.99, p<0.001) and call category 2 (OR 4.44, 95%CI 3.31-5.96 p<0.001). CFRs were also less likely to attend patients from minority ethnic backgrounds, those younger than 39 years, and incidents in more deprived areas. Conclusions CFRs play an important role in EMS delivery, supporting the work of ambulance services, especially in rural areas. The work of CFRs has expanded from its original purpose to attend out-of-hospital cardiac arrest to more types of emergencies. Future development of CFR schemes should prioritise training for a range of conditions, and access to more deprived and ethnically diverse areas.

中文翻译：

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EP10 社区急救人员对英国农村紧急医疗服务提供的贡献

背景 社区急救人员 (CFR) 是由紧急医疗服务 (EMS) 派遣到可能危及生命的紧急情况的志愿者，在救护车工作人员到达之前提供护理。以前的定性研究描述了 CFR 的作用、看法和动机，但缺乏关于他们对农村医疗保健提供贡献的定量证据。我们旨在调查电话的数量、类型和位置（农村或城市），以及就诊患者的特征。方法 我们使用回顾性观察设计分析了 2019 年英格兰十个救护车服务中的六个的常规数据。描述性统计用于直接比较 CFR 首先出席的事件与救护人员出席的事件。使用多元逻辑回归模型来确定 CFR 出勤率的主要预测因素。结果 数据包括一年内的 450 万起事件。与城市地区相比，CFR 首先在农村地区接听电话的比例明显更高（3.90% 对 1.48%，p<0.05）。病死率存在的主要预测因素是农村（优势比 [OR] 2.05, 95% 置信区间 [CI] 1.99-2.11, p<0.001），包括心肺功能在内的条件（OR 9.20, 95% CI 5.08-16.64, p<0.001）或神经/内分泌 (OR 9.26, 95%CI 5.12-16.77, p<0.001) 和最紧急呼叫类别 1 (OR 5.19, 95%CI 3.86-6.99, p<0.001) 和呼叫类别 2 (OR 4.44, 95 %CI 3.31-5.96 p<0.001)。CFR 也不太可能照顾来自少数族裔背景的患者、39 岁以下的患者以及更贫困地区的事件。结论 CFR 在 EMS 交付中发挥重要作用，支持救护车服务的工作，特别是在农村地区。CFRs 的工作已经从最初的目的扩大到处理院外心脏骤停到更多类型的紧急情况。CFR 计划的未来发展应优先考虑针对各种条件的培训，以及进入更贫困和种族多样化的地区。