PP42 Effectiveness of community first responder presence on cardiac arrest outcomes in Lincolnshire; descriptive study
Year: 2024
Type: conference-abstract
Abstract: Background When a 999 call indicates cardiac arrest, the Emergency Operations Centre (EOC) despatches the ambulance and alerts nearby Community First Responders (CFRs). These trained responders play a critical role by providing early, CPR and using AEDs, potentially saving lives. Time of arrival is crucial, as only about 25% of cases reach hospitals alive. Dispatching a CFR to attend an emergency saves time when they are first on the scene. Despite their importance evidence on CFRs’ impact in rural healthcare provision is lacking. Therefore, this study aims to analyse the effectiveness of CFRs presents on cardiac arrest outcomes. Methods We analysed the timing benefits of Community First Responders (CFRs) versus their absence using counterfactual analysis. Counterfactual episodes represent ambulance responses without CFRs. By comparing timings from EMAS and LIVES, we differentiated between CFRs arriving before or after EMAS. Using multivariable regression models, we compared outcomes (return of spontaneous circulation and 30-day survival) for CFR arrival before ambulance versus ambulance alone. Descriptive statistics from routine data (April 2020-December 2021) on out-of-hospital cardiac arrest (OHCA) included incident location, response timing, treatment, ambulance backup, and conveyance. Proportion tests directly compared CFR and ambulance attendances in rural and urban areas. Results Approximately 10% of cardiac arrest incidents had CFRs arriving before ambulance, but this did not improve return of spontaneous circulation (ROSC) or 30-day survival outcomes. CFR attendance was not associated with higher ROSC or survival from OHCA. Conclusions While CFRs achieved response time targets and attended incidents earlier, especially in rural areas, their presence did not improve OHCA outcomes. CFRs were more likely than ambulance crews to be first responders at cardiac arrest episodes. CFR attendance resulted in shorter response times and a higher likelihood of meeting targets compared to ambulance staff without CFRs.
Source: Poster presentations
Institution: University of Lincoln
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4405154946