Background

Time is the crucial factor in the “chain of survival” treatment concept for out-of-hospital cardiac arrest (OHCA). We aimed to measure different response time intervals by comparing emergency medical system (EMS), fire fighters and smartphone aided volunteer responders.

Methods

In two large Swedish regions, volunteer responders were timed from the alert until they arrived at the scene of the suspected OHCA. The first arriving volunteer responders who tried to fetch an automated external defibrillator (AED-responder) and who ran to perform bystander cardiopulmonary resuscitation (CPR-responder) were compared to both the first arriving EMS and fire fighters. Three-time intervals were measured, from call to dispatch, the unit response time (from dispatch to arrival) and the total response time.

Results

During 22 months, 2631 suspected OHCAs were included. The median time from call to dispatch was in minutes 1.8 (95% CI = 1.7–1.8) for EMS, 2.9 (95% CI = 2.8–3.0) for fire-fighters and 3.0 (95% CI = 2.9–3.1) for volunteer responders. The median unit response time was 8.3 (95% CI = 8.1–8.5) for EMS, 6.8 (95% CI = 6.7–6.9) for fire fighters and 6.0 (95% CI = 5.7–6.2) for AED-responders and 4.6 (95% CI = 4.5–4.8) for CPR-responders. The total response time was 10.4 (95% CI = 10.1–10.6) for EMS, 10.2 (95% CI = 9.9–10.4) for fire fighters, 9.6 (95% CI = 9.1–9.8) for AED-responders and 8.2 (95% CI = 8.0–8.3) for CPR-responders.

Conclusion

First arriving volunteer responders had the shortest unit response time when compared to both fire fighters and EMS, however this advantage was reduced by delays introduced at the dispatch center. Earlier automatic dispatch should be considered in further studies.

中文翻译：

---

第一个响应者是第一个吗？疑似院外心脏骤停的集会

背景

时间是院外心脏骤停（OHCA）“生存链”治疗理念中的关键因素。我们的目的是通过比较紧急医疗系统 (EMS)、消防员和智能手机辅助的志愿响应人员来测量不同的响应时间间隔。

方法

在瑞典的两个大地区，志愿响应人员的时间从警报发出到到达疑似 OHCA 现场。将第一批到达的志愿者急救人员试图取自动体外除颤器（AED 应答器）并跑去进行旁观者心肺复苏（CPR 应答器），并将其与第一批到达的 EMS 和消防员进行比较。测量了三个时间间隔，从呼叫到调度、单位响应时间（从调度到到达）和总响应时间。

结果

22 个月内，纳入了 2631 名疑似 OHCA。从接到呼叫到派遣的中位时间为 1.8 分钟（95% CI = 1.7–1.8），对于消防员为 2.9 分钟（95% CI = 2.8–3.0），对于志愿者为 3.0 分钟（95% CI = 2.9–3.1）响应者。EMS的中位单位响应时间为 8.3 (95% CI = 8.1–8.5)，消防员为 6.8 (95% CI = 6.7–6.9)，AED 响应者为 6.0 (95% CI = 5.7–6.2)，AED 响应者为 4.6 (95% CI = 5.7–6.2)。对于 CPR 应答者来说，95% CI = 4.5–4.8）。EMS 的总响应时间为 10.4 (95% CI = 10.1–10.6)，消防员的总响应时间为 10.2 (95% CI = 9.9–10.4)，AED 响应者的总响应时间为 9.6 (95% CI = 9.1–9.8)，AED 响应者的总响应时间为 8.2 (95对于 CPR 应答者，% CI = 8.0–8.3）。

结论

与消防员和急救人员相比，首先到达的志愿响应人员的单位响应时间最短，但由于调度中心的延误，这一优势被削弱了。在进一步的研究中应考虑早期的自动调度。