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Siriwardena AN, Patel G, Botan V, Smith MD, Phung VH, Pattinson J, Trueman I, Ridyard C, Hosseini MP, Asghar Z, Orner R, Brewster A, Mountain P, Rowan E, Spaight R. Community First Responders' role in the current and future rural health and care workforce: a mixed-methods study. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-101. [PMID: 39054745 DOI: 10.3310/jyrt8674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
Background Community First Responders are trained volunteers dispatched by ambulance services to potentially life-threatening emergencies such as cardiac arrest in the first vital minutes to provide care until highly skilled ambulance staff arrive. Community First Responder schemes were first introduced to support ambulance services in rural communities, where access to prehospital emergency care is more likely to be delayed. Evidence is lacking on their contribution to rural healthcare provision, how care is provided and how this might be improved. Objectives We aimed to describe Community First Responder activities, organisation, costs of provision and outcomes of care together with perceptions and views of patients, public, Community First Responders, ambulance service staff and commissioners of their current and future role including innovations in the rural health and care workforce. Design We used a mixed-methods design, using a lens of pragmatism and the 'actor', 'behaviour change' and 'causal pathway' framework to integrate quantitative routine and qualitative (policy, guideline and protocol documents with stakeholder interview) data from 6 of 10 English ambulance services. We identified potential innovations in Community First Responder provision and prioritised these using a modified nominal group technique. Patients and public were involved throughout the study. Results In 4.5 million incidents from six English regional ambulance services during 2019, pre COVID-19 pandemic, Community First Responders attended first a higher proportion of calls in rural areas (almost 4% of calls) than in urban areas (around 1.5%). They were significantly more likely to be called out to rural (vs. urban) areas and to attend older (vs. younger), white (vs. minority ethnic) people in more affluent (vs. deprived) areas with cardiorespiratory and neurological (vs. other emergency) conditions for higher-priority emergency or urgent (category 1 and 2 compared with category 3, 4 or 5) calls but did also attend lower-category calls for conditions such as falls. We examined 10 documents from seven ambulance services. Ambulance policies and protocols integrated Community First Responders into ambulance service structures to achieve the safe and effective operation of volunteers. Costs, mainly for training, equipment and support, varied widely but were not always clearly delineated. Community First Responders enabled a faster prehospital response time. There was no clear benefit in out-of-hospital cardiac arrest outcomes. A specific Community First Responder falls response reduced ambulance attendances and was potentially cost saving. We conducted semistructured interviews with 47 different stakeholders engaged in Community First Responder functions. This showed the trajectory of becoming a Community First Responder, the Community First Responder role, governance and practice, and the positive views of Community First Responders from stakeholders despite public lack of understanding of their role. Community First Responders' scope of practice varied between ambulance services and had developed into new areas. Innovations prioritised at the consensus workshop were changes in processes and structures and an expanded scope of practice supported by training, which included counselling, peer support, better communication with the control room, navigation and communication technology, and specific mandatory and standardised training for Community First Responders. Limitations Missing data and small numbers of interviews in some stakeholder groups (patients, commissioners) are sources of bias. Future research Future research should include a robust evaluation of innovations involving Community First Responders. Trial registration This trial is registered as ClinicalTrials.gov, NCT04279262. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR127920) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 18. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
| | - Gupteswar Patel
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - Vanessa Botan
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - Murray D Smith
- Aberystwyth Business School, Aberystwyth University, Aberystwyth, UK
| | - Viet-Hai Phung
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - Julie Pattinson
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - Ian Trueman
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - Colin Ridyard
- Centre for Health Economics and Medicines Evaluation, Bangor University, Bangor, UK
| | - Mehrshad Parvin Hosseini
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - Zahid Asghar
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - Roderick Orner
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - Amanda Brewster
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - Pauline Mountain
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, UK
| | - Elise Rowan
- Community and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, UK
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Li N, Shen C, Yang X, Wang R, Gu LQ, Zhao W, Chu ZP. The Real Experience of Lay Responders Performing Cardiopulmonary Resuscitation: A Synthesis of Qualitative Evidence. Public Health Rev 2024; 45:1606650. [PMID: 38903868 PMCID: PMC11188311 DOI: 10.3389/phrs.2024.1606650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 05/24/2024] [Indexed: 06/22/2024] Open
Abstract
Objectives To synthesize qualitative evidence on the experience of lay responders performing cardiopulmonary resuscitation (CPR). Methods Qualitative evidence synthesis was performed using the Thomas and Harden method. The PubMed, Cochrane Library, Web of Science, OVID Medline, Embase, CINAHL, CNKI, and WanFang databases were systematically searched. The quality of the research was assessed by the Critical Assessment Skills Program Tool (CASP). Results A total of 5,610 studies were identified, and 9 studies were included in the analysis. Four analytical themes were generated: emotional ambivalence before CPR, psychological tolerance during CPR, perceived experience after CPR, and enhancing psychological resilience. Conclusion Lay responders face complicated psychological experience during CPR, which may be susceptible to psychological effects such as "loss aversion," "bystander effects" and "knowledge curse." In addition to the timely retraining of CPR, lay responders should be instructed to manage psychological distress and improve psychological resilience. More importantly, the psychological sequelae may be long-lasting, requiring ongoing psychological intervention and follow-up based on valuing transdisciplinarity across endeavours.
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Affiliation(s)
- Na Li
- Second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chen Shen
- Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xin Yang
- Second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Rao Wang
- Second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lian Qi Gu
- Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wei Zhao
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhi Ping Chu
- Second Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
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Allert C, Nilsson B, Svensson A, Andersson EK. Voluntary first responders' experiences of being dispatched to suspected out-of-hospital cardiac arrest in rural areas: an interview study. BMC Cardiovasc Disord 2024; 24:157. [PMID: 38486144 PMCID: PMC10938808 DOI: 10.1186/s12872-024-03826-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Out-of-hospital cardiac arrest (OHCA) is a leading cause of death, and survival outcomes vary across countries and regions. To improve survival, the European Resuscitation Council Guidelines encourage the implementation of technologies like smartphone applications to alert voluntary first responders (VFRs) who are near a suspected OHCA. VFRs are of great importance in the ´chain of survival´, but there is still a lack of knowledge about their experiences; especially of those operating in rural areas. Understanding those experiences is crucial in developing appropriate interventions to train, encourage, and safeguard VFRs in their mission. Therefore, the aim of this study was to describe VFRs´ experiences of being dispatched to suspected OHCA in rural areas. METHODS The study used an inductive design. The data were collected using individual interviews with 16 VFRs and analysed using qualitative content analysis. RESULTS The results are presented in terms of six generic categories ''Being motivated and prepared'', ''Having strategies to undertake the mission'', ''Collaborating with others'', ''Being ethically aware'', ''Supporting the family members'', and ''Coping with the mission'', which formed the basis of the main category 'Desire to save lives and help others'. The findings showed that VFRs had a genuine desire to contribute to save lives in this rural area. Regardless of the circumstances, they were prepared to leave everything and act to the best for the victim and their family members. In theirs' missions they collaborated with others at the scene and were guided by ethics while they acted in complex circumstances. CONCLUSIONS VFRs dispatched in rural areas express a desire to save lives. In their missions, they acted in complex situations and experienced both emotional and ethical challenges. The design, implementation, and evaluation of support interventions directed at VFRs should be prioritised, especially in rural areas, as it can contribute to more people becoming and remaining VFRs, which in turn could contribute to sustainable development.
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Affiliation(s)
- Camilla Allert
- Department of Health and Caring Sciences, University Lecturer Faculty of Health and Life Sciences Linnaeus University, 392 31, Växjö/Kalmar, Sweden.
- Centre of Interprofessional Collaboration Within Emergency Care (CICE), Linnaeus University, Växjö, Sweden.
| | - Bengt Nilsson
- Department of Forestry and Wood Technology, Linnaeus University, Växjö, Sweden
- Centre of Interprofessional Collaboration Within Emergency Care (CICE), Linnaeus University, Växjö, Sweden
- Agunnaryd Voluntary Fire Brigade, Ljungby, Sweden
| | - Anders Svensson
- Department of Health and Caring Sciences, University Lecturer Faculty of Health and Life Sciences Linnaeus University, 392 31, Växjö/Kalmar, Sweden
- Centre of Interprofessional Collaboration Within Emergency Care (CICE), Linnaeus University, Växjö, Sweden
- Department of Ambulance Service, Region Kronoberg, Växjö, Sweden
| | - Ewa K Andersson
- Department of Health and Caring Sciences, University Lecturer Faculty of Health and Life Sciences Linnaeus University, 392 31, Växjö/Kalmar, Sweden
- Centre of Interprofessional Collaboration Within Emergency Care (CICE), Linnaeus University, Växjö, Sweden
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Sørensen OB, Milling L, Laerkner E, Mikkelsen S, Bruun H. Professional prehospital clinicians' experiences of ethical challenges associated with the collaboration with organised voluntary first responders: a qualitative study. Scand J Trauma Resusc Emerg Med 2023; 31:79. [PMID: 37964364 PMCID: PMC10644536 DOI: 10.1186/s13049-023-01147-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 11/07/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Volunteer First Responders are used worldwide. In the Region of Southern Denmark, two types of programs have been established. One of these programs consists of voluntary responders without any requirements of education or training who are summoned to prehospital cardiac arrests. The other type of program is established primarily in the rural areas of the region and consists of volunteers with some mandatory education in first aid. These volunteers are summoned to all urgent cases along with the ambulances. Cooperation between professional healthcare workers and nonprofessionals summoned through official channels may be challenging. This study aimed to explore prehospital clinicians' experiences of ethical challenges in cooperation with volunteer first responders. METHODS We conducted 16 semi-structured interviews at four different ambulance stations in the Region of Southern Denmark. Five emergency physicians and 11 emergency medical technicians/paramedics were interviewed. The interviews were transcribed, and the data were analysed using systematic text condensation. RESULTS The study's 16 interviews resulted in the identification of some specific categories that challenged the cooperation between the two parties. We identified three main categories: 1. Beneficence, the act of doing good, 2. The risk of harming patients' autonomy 3. Non-maleficence, which is the obligation not to inflict harm on others. CONCLUSION This study provides an in-depth insight into the ethical challenges between prehospital clinicians and voluntary first responders from the perspective of the prehospital clinicians. Both programs are considered to have value but only when treating patients with cardiac arrest. Our study highlights potential areas of improvement in the two Danish voluntary programs in their current form.
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Affiliation(s)
- Oliver Beierholm Sørensen
- Department of Clinical Research, University of Southern Denmark, 5000, Odense, Denmark
- The Prehospital Research Unit, Region of Southern Denmark, Odense University Hospital, 5000, Odense, Denmark
| | - Louise Milling
- The Prehospital Research Unit, Region of Southern Denmark, Odense University Hospital, 5000, Odense, Denmark
- Department of Regional Health Research, University of Southern Denmark, 5000, Odense, Denmark
- Department of Cardiology, Nord Zealand Hospital, 3400, Hillerød, Denmark
| | - Eva Laerkner
- Department of Anaesthesiology and Intensive Care Medicine, Odense University Hospital, 5000, Odense, Denmark
- Department of Clinical Research, Research Unit in Anesthesiology, University of Southern Denmark, 5000, Odense, Denmark
| | - Søren Mikkelsen
- The Prehospital Research Unit, Region of Southern Denmark, Odense University Hospital, 5000, Odense, Denmark.
- Department of Regional Health Research, University of Southern Denmark, 5000, Odense, Denmark.
- Department of Anaesthesiology and Intensive Care Medicine, Odense University Hospital, 5000, Odense, Denmark.
| | - Henriette Bruun
- The Prehospital Research Unit, Region of Southern Denmark, Odense University Hospital, 5000, Odense, Denmark
- Department of Regional Health Research, University of Southern Denmark, 5000, Odense, Denmark
- Psychiatric Department Middelfart, Mental Health Services in the Region of Southern Denmark, 5500, Middelfart, Denmark
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Schnaubelt S, Orlob S, Veigl C, Sulzgruber P, Krammel M, Lauridsen KG, Greif R. Out of sight - Out of mind? The need for a professional and standardized peri-mission first responder support model. Resusc Plus 2023; 15:100449. [PMID: 37638096 PMCID: PMC10448200 DOI: 10.1016/j.resplu.2023.100449] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
First responders are an essential part of the chain (-mail) of survival as they bridge and reduce the time to first chest compressions and defibrillation substantially. However, in the peri-mission phase before and after being sent to a cardiac arrest, these first responders are in danger of being forgotten and taken for granted, and the potential psychological impact has to be remembered. We propose a standardized first responder support system (FRSS) that needs to ensure that first responders are valued and cared for in terms of psychological safety and continuing motivation. This multi-tiered program should involve tailored education and standardized debriefing, as well as actively seeking contact with the first responders after their missions to facilitate potentially needed professional psychological support.
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Affiliation(s)
- Sebastian Schnaubelt
- Department of Emergency Medicine, Medical University of Vienna, Austria
- PULS – Austrian Cardiac Arrest Awareness Association, Vienna, Austria
- Austrian Resuscitation Council, Graz, Austria
- Department of Emergency Medicine, Antwerp University Hospital, Edegem, Belgium
| | - Simon Orlob
- Austrian Resuscitation Council, Graz, Austria
- Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Austria
- Drueck Mich! Arbeitsgemeinschaft fuer Notfallmedizin, Graz, Austria
| | - Christoph Veigl
- Department of Emergency Medicine, Medical University of Vienna, Austria
- PULS – Austrian Cardiac Arrest Awareness Association, Vienna, Austria
| | - Patrick Sulzgruber
- PULS – Austrian Cardiac Arrest Awareness Association, Vienna, Austria
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Austria
| | - Mario Krammel
- PULS – Austrian Cardiac Arrest Awareness Association, Vienna, Austria
- Emergency Medical Service Vienna, Austria
| | - Kasper G. Lauridsen
- Department of Medicine, Randers Regional Hospital, Randers, Denmark
- Research Center for Emergency Medicine, Aarhus University, Aarhus, Denmark
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, USA
| | - Robert Greif
- University of Bern, Switzerland
- School of Medicine, Sigmund Freud University, Vienna, Austria
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Prytz E, Norrblom P, Pilemalm S, Andersson Granberg T, Jonson CO. What motivates and demotivates emergency response volunteers? A survey-based factor analysis study. Scand J Trauma Resusc Emerg Med 2023; 31:38. [PMID: 37568197 PMCID: PMC10422740 DOI: 10.1186/s13049-023-01101-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 07/16/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Organized volunteer initiatives can reduce response times and improve outcomes in emergencies such as cardiac arrests or fires. Retention of volunteers is important to maintain good coverage and capabilities. The current study explores factors underlying volunteers' motivation to continue as volunteers. METHODS Data from 5347 active volunteers were collected through an online survey. An exploratory factor analysis was used to identify underlying factors that were then used in a regression analysis to predict intention to continue as a volunteer. Group differences based on, among others, number of alarms and prior professional experience in emergency response were explored. RESULTS The results showed that the factors community, self-image, and competence were the strongest positive predictors for the motivation to continue, whereas alarm fatigue and negative experience were the strongest negative predictors. Volunteers with professional background had higher competence and lower Alarm fatigue. Volunteers from rural areas and small cities had higher community than those in large cities. CONCLUSIONS Alarm fatigue can make it hard to retain volunteers, which could be addressed using improved dispatch algorithms. Support after dispatch is important to prevent negative experiences. Finally, increased competence, e.g. through education and training, can improve volunteer's motivation to continue.
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Affiliation(s)
- Erik Prytz
- Department of Computer and Information Science, Linköping University, Linköping, Sweden.
| | - Petter Norrblom
- Department of Computer and Information Science, Linköping University, Linköping, Sweden
| | - Sofie Pilemalm
- Department of Science and Technology, Linköping University, Linköping, Sweden
- Department of Information Systems, University of Agder, Kristiansand, Norway
| | | | - Carl-Oscar Jonson
- Center for Disaster Medicine and Traumatology, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Rolin Kragh A, Tofte Gregers M, Andelius L, Shahriari P, Kjærholm S, Korsgaard A, Folke F, Malta Hansen C. Follow-up on volunteer responders dispatched for out-of-hospital cardiac arrests: Addressing the psychological and physical impact. Resusc Plus 2023; 14:100402. [PMID: 37287956 PMCID: PMC10242620 DOI: 10.1016/j.resplu.2023.100402] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
Introduction Smartphone technology is increasingly used to engage lay people as volunteer responders in resuscitation attempts. Attention has recently been drawn to how resuscitation attempts may impact bystanders. Attempting resuscitation in out-of-hospital cardiac arrests (OHCA) may be an overwhelming experience and, in some cases, difficult to cope with. We developed a volunteer responder follow-up program to systematically measure the psychological and physical impact on volunteer responders dispatched for OHCAs. Methods and Results The nationwide Danish volunteer responder program dispatches volunteer responders for presumed cardiac arrests. 90 min after notification of a potential nearby cardiac arrest, all volunteer responders receive a survey, and are asked to self-report their mental state of mind after the event. The volunteer responders are also asked to disclose any physical injury they sustained in relation to the event. Volunteer responders who report severe mental effects are offered a defusing conversation by a trained nurse. Between 1 September 2017 and 31 December 2022, the Danish volunteer responder program has alerted 177,866 volunteer responders for 10,819 presumed cardiac arrest alerts. Of 177,866 alerted volunteers responders, 62,711 accepted the alarm. In the same period, 7,317 cancelled their registration. From January 2019 to 31 December 31 2022, a total of 535 volunteer responders were offered a defusing consultation. Conclusion The Danish volunteer responder follow-up program is carried out to assess the psychological and physical risks of responding to a suspected OHCA. We suggest a survey-based method for systematic screening of volunteer responders that allow volunteer responders to report any physical injury or need of psychological follow-up. The person providing defusing should be a trained and experienced healthcare professional.
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Affiliation(s)
- Astrid Rolin Kragh
- Copenhagen Emergency Medical Services, Denmark
- University of Copenhagen, Department of Clinical Medicine, Denmark
| | - Mads Tofte Gregers
- Copenhagen Emergency Medical Services, Denmark
- University of Copenhagen, Department of Clinical Medicine, Denmark
| | - Linn Andelius
- Copenhagen Emergency Medical Services, Denmark
- University of Copenhagen, Department of Clinical Medicine, Denmark
| | - Persia Shahriari
- Copenhagen Emergency Medical Services, Denmark
- University of Copenhagen, Department of Clinical Medicine, Denmark
| | | | - Anders Korsgaard
- Department of Psychology, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Fredrik Folke
- Copenhagen Emergency Medical Services, Denmark
- Department of Cardiology, University Hospital Gentofte, Copenhagen, Denmark
- University of Copenhagen, Department of Clinical Medicine, Denmark
| | - Carolina Malta Hansen
- Copenhagen Emergency Medical Services, Denmark
- Department of Cardiology, University Hospital Gentofte, Copenhagen, Denmark
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Kragh AR, Grabmayr AJ, Tjørnhøj-Thomsen T, Zinckernagel L, Gregers MCT, Andelius LC, Christensen AK, Kjærgaard J, Folke F, Malta Hansen C. Volunteer responder provision of support to relatives of out-of-hospital cardiac arrest patients: a qualitative study. BMJ Open 2023; 13:e071220. [PMID: 36944472 PMCID: PMC10032384 DOI: 10.1136/bmjopen-2022-071220] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
OBJECTIVES Smartphone dispatch of volunteer responders for out-of-hospital cardiac arrest (OHCA) is implemented worldwide. While basic life support courses prepare participants to provide CPR, the courses rarely address the possibility of meeting a family member or relative in crisis. This study aimed to examine volunteer responders' provision of support to relatives of cardiac arrest patients and how relatives experienced the interaction with volunteer responders. DESIGN In this qualitative study, we conducted 16 semistructured interviews with volunteer responders and relatives of cardiac arrest patients. SETTING Interviews were conducted face to face and by video and recorded and transcribed verbatim. PARTICIPANTS Volunteer responders dispatched to cardiac arrests and relatives of cardiac arrest patients were included in the study. Participants were included from all five regions of Denmark. RESULTS A thematic analysis was performed with inspiration from Braun and Clarke. We identified three themes: (1) relatives' experiences of immediate relief at arrival of assistance, (2) volunteer responders' assessment of relatives' needs and (3) the advantage of being healthcare educated. CONCLUSIONS Relatives to out-of-hospital cardiac arrest patients benefited from volunteer responders' presence and support and experienced the mere presence of volunteer responders as supportive. Healthcare-educated volunteer responders felt confident and skilled to provide care for relatives, while some non-healthcare-educated volunteer responders felt they lacked the proper training and knowledge to provide emotional support for relatives. Future basic life support courses should include a lesson on how to provide emotional support to relatives of cardiac arrest patients.
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Affiliation(s)
- Astrid Rolin Kragh
- Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Department of Emergency Medical Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Anne Juul Grabmayr
- Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Department of Emergency Medical Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Tine Tjørnhøj-Thomsen
- University of Southern Denmark, National Institute of Public Health, Copenhagen, Denmark
| | | | - Mads Christian Tofte Gregers
- Department of Clinical Medicine, University of Copenhagen Faculty of Health and Medical Sciences, Copenhagen, Denmark
- Department of Emergency Medical Services, Capital Region of Denmark, Copenhagen, Denmark
| | | | | | - Jesper Kjærgaard
- Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Fredrik Folke
- Department of Emergency Medical Services, Capital Region of Denmark, Copenhagen, Denmark
- Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark
| | - Carolina Malta Hansen
- Department of Emergency Medical Services, Capital Region of Denmark, Copenhagen, Denmark
- Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark
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"It's like a swan, all nice and serene on top, and paddling like hell underneath": community first responders' practices in attending patients and contributions to rapid emergency response in rural England, United Kingdom-a qualitative interview study. SCANDINAVIAN JOURNAL OF TRAUMA, RESUSCITATION AND EMERGENCY MEDICINE 2023; 31:7. [PMID: 36782273 PMCID: PMC9924885 DOI: 10.1186/s13049-023-01071-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/29/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND Community First Responder (CFR) schemes are a long-established service supplementing ambulance trusts in their local community in the United Kingdom. CFRs are community members who volunteer to respond to people with life-threatening conditions. Previous studies highlighted the motivations for becoming CFRs, their training, community (un)awareness and implications of their work on themselves and others. The practices of CFRs in prehospital care remain underexplored. Therefore, we aimed to explore real-world practice of Community First Responders and their contribution to prehospital emergency care. METHODS We conducted 47 interviews with CFRs (21), CFR leads (15), ambulance clinicians (4), commissioners (2) and patients and relatives (5) from six ambulance services and regions of England, United Kingdom. Thematic analysis enabled identification of themes and subthemes, with subsequent interpretation built on the theory of practice wisdom. RESULTS Our analysis revealed the embeddedness of the concept of doing the right thing at the right time in CFR practice. CFRs' work consisted of a series of sequential and interconnected activities which included: identifying patients' signs, symptoms and problems; information sharing with the ambulance control room on the patient's condition; providing a rapid emergency response including assessment and care; and engaging with ambulance clinicians for patient transfer. The patient care sequence began with recognising patients' signs and symptoms, and validation of patient information provided by the ambulance control room. The CFRs shared patient information with ambulance control who in turn notified the ambulance crew en-route. The practices of CFRs also included delivery of emergency care before ambulance clinicians arrived. Following the delivery of a rapid emergency response, CFRs engaged with the ambulance crew to facilitate patient transfer to the nearest medical facility. CONCLUSION The sequential CFR practices supported ambulance services in delivering prehospital and emergency care in rural areas. CFR practices were founded on the principle of practice wisdom where CFRs constructed their practice decisions based on the patient's condition, their training, availability of equipment and medications and their scope of practice.
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Botan V, Asghar Z, Rowan E, Smith MD, Patel G, Phung VH, Trueman I, Spaight R, Brewster A, Mountain P, Orner R, Siriwardena AN. Community First Responders' Contribution to Emergency Medical Service Provision in the United Kingdom. Ann Emerg Med 2023; 81:176-183. [PMID: 35940990 DOI: 10.1016/j.annemergmed.2022.05.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/09/2022] [Accepted: 05/23/2022] [Indexed: 01/28/2023]
Abstract
STUDY OBJECTIVE We aimed to investigate community first responders' contribution to emergency care provision in terms of number, rate, type, and location of calls and characteristics of patients attended. METHODS We used a retrospective observational design analyzing routine data from electronic clinical records from 6 of 10 ambulance services in the United Kingdom during 2019. Descriptive statistics, including numbers and frequencies, were used to illustrate characteristics of incidents and patients that the community first responders attended first in both rural and urban areas. RESULTS The data included 4.5 million incidents during 1 year. The community first responders first attended a higher proportion of calls in rural areas compared with those in urban areas (3.90% versus 1.48 %). In rural areas, the community first responders also first attended a higher percentage of the most urgent call categories, 1 and 2. The community first responders first attended more than 9% of the total number of category 1 calls and almost 5% of category 2 calls. The community first responders also attended a higher percentage of the total number of cardiorespiratory and neurological/endocrine conditions. They first attended 6.5% of the total number of neurological/endocrine conditions and 5.9% of the total number of cardiorespiratory conditions. Regarding arrival times in rural areas, the community first responders attended higher percentages (more than 6%) of the total number of calls that had arrival times of less than 7 minutes or more than 60 minutes. CONCLUSION In the United Kingdom, community first responders contribute to the delivery of emergency medical services, particularly in rural areas and especially for more urgent calls. The work of community first responders has expanded from their original purpose-to attend to out-of-hospital cardiac arrests. The future development of community first responders' schemes should prioritize training for a range of conditions, and further research is needed to explore the contribution and potential future role of the community first responders from the perspective of service users, community first responders' schemes, ambulance services, and commissioners.
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Affiliation(s)
- Vanessa Botan
- Community and Health Research Unit, School of Health and Social Care, Lincoln Medical School, University of Lincoln, Lincoln, United Kingdom
| | - Zahid Asghar
- Community and Health Research Unit, School of Health and Social Care, Lincoln Medical School, University of Lincoln, Lincoln, United Kingdom
| | - Elise Rowan
- Community and Health Research Unit, School of Health and Social Care, Lincoln Medical School, University of Lincoln, Lincoln, United Kingdom
| | - Murray D Smith
- Community and Health Research Unit, School of Health and Social Care, Lincoln Medical School, University of Lincoln, Lincoln, United Kingdom
| | - Gupteswar Patel
- Community and Health Research Unit, School of Health and Social Care, Lincoln Medical School, University of Lincoln, Lincoln, United Kingdom
| | - Viet-Hai Phung
- Community and Health Research Unit, School of Health and Social Care, Lincoln Medical School, University of Lincoln, Lincoln, United Kingdom
| | - Ian Trueman
- Community and Health Research Unit, School of Health and Social Care, Lincoln Medical School, University of Lincoln, Lincoln, United Kingdom
| | - Robert Spaight
- East Midlands Ambulance Service NHS Trust, Cross O'Cliff Court, Bracebridge Heath, Lincoln, United Kingdom
| | - Amanda Brewster
- Community and Health Research Unit, School of Health and Social Care, Lincoln Medical School, University of Lincoln, Lincoln, United Kingdom
| | - Pauline Mountain
- Community and Health Research Unit, School of Health and Social Care, Lincoln Medical School, University of Lincoln, Lincoln, United Kingdom
| | - Roderick Orner
- Community and Health Research Unit, School of Health and Social Care, Lincoln Medical School, University of Lincoln, Lincoln, United Kingdom
| | - Aloysius Niroshan Siriwardena
- Community and Health Research Unit, School of Health and Social Care, Lincoln Medical School, University of Lincoln, Lincoln, United Kingdom.
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11
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Slingers M, De Vos S, Sun JH. Ten years of the community-based emergency first aid responder (EFAR) system in the Western Cape of South Africa: What has happened, what has changed, and what has been learned. Afr J Emerg Med 2022; 12:299-306. [PMID: 35892007 PMCID: PMC9307512 DOI: 10.1016/j.afjem.2022.06.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 05/10/2022] [Accepted: 06/20/2022] [Indexed: 11/02/2022] Open
Abstract
The emergency first aid responder (EFAR) system was designed as a low-cost and adaptable community-based prehospital emergency care system, and was first published after conducting a study in the township of Manenberg, South Africa, in 2010. EFARs are laypersons who are trained to respond to emergencies in their communities, and can provide support to the emergency medical services (EMS) by providing early clinical care, reporting back about the scene, and assisting with local scene management and logistics. Over the past ten years in South Africa, the Western Cape Government Health (WCGH) EMS and the Western Cape Government (WCG) College of Emergency Care have implemented the EFAR system in multiple communities and have trained over 10,000 community members across the Western Cape. This report is a ten-year update on what has happened since the EFAR system started, and to candidly show how the system has evolved, what has been learned, and what challenges remain so that others could look ahead and plan accordingly as they develop similar community-based first aid responder systems in resource-constrained areas. Core pillars to the EFAR system's success have included community involvement and adaptation, collaboration with the WCGH EMS and WCG College of Emergency Care, opportunities for community and EMS development, and emphasis on the sustainability of local EFAR systems. Multiple challenges also remain that others may likely face.
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Affiliation(s)
- Marcus Slingers
- Western Cape Government College of Emergency Care.,Western Cape Government Health Emergency Medical Services
| | - Simonay De Vos
- Western Cape Government College of Emergency Care.,Western Cape Government Health Emergency Medical Services
| | - Jared H Sun
- University of Cape Town, Division of Emergency Medicine
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12
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Orsi A, Watson A, Wijegoonewardene N, Botan V, Lloyd D, Dunbar N, Asghar Z, Siriwardena AN. Perceptions and experiences of medical student first responders: a mixed methods study. BMC MEDICAL EDUCATION 2022; 22:721. [PMID: 36242030 PMCID: PMC9561313 DOI: 10.1186/s12909-022-03791-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 09/23/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
CONTEXT Medical Student First Responders (MSFRs) are volunteers who respond to emergency calls, managing patients before ambulance staff attend. The MSFR role provides opportunities to manage acutely unwell patients in the prehospital environment, not usually offered as part of formal undergraduate medical education. There are few previous studies describing activities or experiences of MSFRs or exploring the potential educational benefits. We aimed to investigate the activity of MSFRs and explore their experiences, particularly from an educational perspective. METHODS We used a mixed methods design, combining quantitative analysis of ambulance dispatch data with qualitative semi-structured interviews of MSFRs. Dispatch data were from South Central and East Midlands Ambulance Service NHS Trusts from 1st January to 31st December 2019. Using propensity score matching, we compared incidents attended by MSFRs with those attended by other Community First Responders (CFRs) and ambulance staff. We interviewed MSFRs from five English (UK) medical schools in those regions about their experiences and perceptions and undertook thematic analysis supported by NVivo 12. RESULTS We included 1,939 patients (median age 58.0 years, 51% female) attended by MSFRs. Incidents attended were more urgent category calls (category 1 n = 299, 14.9% and category 2 n = 1,504, 77.6%), most commonly for chest pain (n = 275, 14.2%) and shortness of breath (n = 273, 14.1%). MSFRs were less likely to attend patients of white ethnicity compared to CFRs and ambulance staff, and more likely to attend incidents in areas of higher socioeconomic deprivation (IMD - index of multiple deprivation) (p < 0.05). Interviewees (n = 16) consistently described positive experiences which improved their clinical and communication skills. CONCLUSION MSFRs' attendance at serious medical emergencies provide a range of reported educational experiences and benefits. Further studies are needed to explore whether MSFR work confers demonstrable improvements in educational or clinical performance.
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Affiliation(s)
- Andrew Orsi
- Community and Health Research Unit, University of Lincoln, Lincoln, UK
- East Midlands School of Anaesthesia, Health Education England, Leeds, UK
| | - Adam Watson
- Medical Science Division, University of Oxford, Oxford, UK
| | | | - Vanessa Botan
- Community and Health Research Unit, University of Lincoln, Lincoln, UK
| | - Dylan Lloyd
- Medical School, University of Buckingham, Buckingham, UK
| | - Nic Dunbar
- South Central Ambulance Service NHS Foundation Trust, Otterbourne, UK
| | - Zahid Asghar
- Community and Health Research Unit, University of Lincoln, Lincoln, UK
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13
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Barry T, Batt A, Agarwal G, Booker M, Casey M, McCombe G. Potential for Paramedic roles in Irish General Practice: A qualitative study of stakeholder’s perspectives. HRB Open Res 2022; 5:40. [PMID: 36072818 PMCID: PMC9418754 DOI: 10.12688/hrbopenres.13545.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Irish health policy emphasises the role of Primary Care and General Practice however, there is a growing shortage of General Practitioners (GPs) in Ireland. Paramedics have traditionally focused on emergency care in the community. More recently Paramedics have taken on roles in General Practice in international jurisdictions, but not yet in Ireland. This study aimed to explore key stakeholder perceptions of ‘the potential for Paramedic roles in Irish General Practice’. Methods: We conducted an exploratory, qualitative stakeholder consultation study incorporating in-depth semi structured telephone interviews followed by thematic analysis. Interviews were conducted with a total of eighteen participants that included six senior Paramedics (Advanced Paramedics), seven General Practitioners (GPs), three Practice Nurses and two Practice Managers. Results: Participants in this study expressed polarised views on the potential for Paramedic roles in Irish General Practice. Paramedics were enthusiastic, highlighting opportunity for professional development and favourable working conditions. GPs, Practice Nurses and Managers were more circumspect and had concerns that Paramedic scope and skillset was not currently aligned to General Practice care. GPs, Practice Nurses and Managers emphasised a greater role for expanded General Practice Nursing. There were varied perceptions on what the potential role of a Paramedic in General Practice might entail, but consensus that Government support would be required to facilitate any potential developments. Conclusions: The findings of this research can inform future development of novel roles in Irish General Practice and suggests that there is appetite from within the Paramedic profession to pursue such roles. A pilot demonstration project, grounded in an action research framework could address data gaps and potential concerns. Any future developments should occur in tandem with and with due consideration for the expansion of General Practice Nursing in Ireland.
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Affiliation(s)
- Tomás Barry
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Alan Batt
- Paramedic Programs, Fanshawe College, London, Ontario, Canada
| | - Gina Agarwal
- Departments of Family Medicine and Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Matthew Booker
- Centre for Academic Primary Care (CAPC), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Mary Casey
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Geoff McCombe
- School of Medicine, University College Dublin, Dublin, Ireland
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14
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Barry T, Batt A, Agarwal G, Booker M, Casey M, McCombe G. Potential for Paramedic roles in Irish General Practice: A qualitative study of stakeholder’s perspectives. HRB Open Res 2022; 5:40. [DOI: 10.12688/hrbopenres.13545.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Irish health policy emphasises the role of Primary Care and General Practice however, there is a growing shortage of General Practitioners (GPs) in Ireland. Paramedics have traditionally focused on emergency care in the community. More recently Paramedics have taken on roles in General Practice in international jurisdictions, but not yet in Ireland. This study aimed to explore key stakeholder perceptions of ‘the potential for Paramedic roles in Irish General Practice’. Methods: We conducted an exploratory, qualitative stakeholder consultation study incorporating in-depth semi structured telephone interviews followed by thematic analysis. Interviews were conducted with a total of eighteen participants that included six senior Paramedics (Advanced Paramedics), seven General Practitioners (GPs), three Practice Nurses and two Practice Managers. Results: Participants in this study expressed polarised views on the potential for Paramedic roles in Irish General Practice. Paramedics were enthusiastic, highlighting opportunity for professional development and favourable working conditions. GP’s, Practice Nurses and Managers were more circumspect and had concerns that Paramedic scope and skillset was not currently aligned to General Practice care. GP’s, Practice Nurses and Managers emphasised a greater role for expanded General Practice Nursing. There were varied perceptions on what the potential role of a Paramedic in General Practice might entail, but consensus that Government support would be required to facilitate any potential developments. Conclusions: The findings of this research can inform future development of novel roles in Irish General Practice and suggests that there is appetite from within the Paramedic profession to pursue such roles. A pilot demonstration project, grounded in an action research framework could address data gaps and potential concerns. Any future developments should occur in tandem with and with due consideration for the expansion of General Practice Nursing in Ireland.
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15
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Högstedt A, Thuccani M, Carlström E, Claesson A, Bremer A, Ravn-Fischer A, Berglund E, Ringh M, Hollenberg J, Herlitz J, Rawshani A, Lundgren P. Characteristics and motivational factors for joining a lay responder system dispatch to out-of-hospital cardiac arrests. Scand J Trauma Resusc Emerg Med 2022; 30:22. [PMID: 35331311 PMCID: PMC8943963 DOI: 10.1186/s13049-022-01009-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 03/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background There has been in increase in the use of systems for organizing lay responders for suspected out-of-hospital cardiac arrests (OHCAs) dispatch using smartphone-based technology. The purpose is to increase survival rates; however, such systems are dependent on people’s commitment to becoming a lay responder. Knowledge about the characteristics of such volunteers and their motivational factors is lacking. Therefore, we explored characteristics and quantified the underlying motivational factors for joining a smartphone-based cardiopulmonary resuscitation (CPR) lay responder system. Methods In this descriptive cross-sectional study, 800 consecutively recruited lay responders in a smartphone-based mobile positioning first-responder system (SMS-lifesavers) were surveyed. Data on characteristics and motivational factors were collected, the latter through a modified version of the validated survey “Volunteer Motivation Inventory” (VMI). The statements in the VMI, ranked on a Likert scale (1–5), corresponded to(a) intrinsic (an inner belief of doing good for others) or (b) extrinsic (earning some kind of reward from the act) motivational factors. Results A total of 461 participants were included in the final analysis. Among respondents, 59% were women, 48% between 25 and 39 years of age, 37% worked within health care, and 66% had undergone post-secondary school. The most common way (44%) to learn about the lay responder system was from a CPR instructor. A majority (77%) had undergone CPR training at their workplace. In terms of motivation, where higher scores reflect greater importance to the participant, intrinsic factors scored highest, represented by the category values (mean 3.97) followed by extrinsic categories reciprocity (mean 3.88) and self-esteem (mean 3.22). Conclusion This study indicates that motivation to join a first responder system mainly depends on intrinsic factors, i.e. an inner belief of doing good, but there are also extrinsic factors, such as earning some kind of reward from the act, to consider. Focusing information campaigns on intrinsic factors may be the most important factor for successful recruitment. When implementing a smartphone-based lay responder system, CPR instructors, as a main information source to potential lay responders, as well as the workplace, are crucial for successful recruitment. Supplementary Information The online version contains supplementary material available at 10.1186/s13049-022-01009-1.
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Affiliation(s)
- A Högstedt
- Prehospen - Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.
| | - M Thuccani
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - E Carlström
- Institute of Healthcare Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.,USN School of Business, University of South-Eastern Norway, Kongsberg, Norway
| | - A Claesson
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - A Bremer
- Prehospen - Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.,Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
| | - A Ravn-Fischer
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - E Berglund
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - M Ringh
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - J Hollenberg
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - J Herlitz
- Prehospen - Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - A Rawshani
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - P Lundgren
- Prehospen - Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden.,Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden
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16
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Keegan D, Heffernan E, McSharry J, Barry T, Masterson S. Identifying priorities for the collection and use of data related to community first response and out-of-hospital cardiac arrest: protocol for a nominal group technique study. HRB Open Res 2021; 4:81. [PMID: 34909578 PMCID: PMC8637246 DOI: 10.12688/hrbopenres.13347.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction: Out-of-hospital cardiac arrest (OHCA) is a devastating health event that affects over 2000 people each year in Ireland. Survival rate is low, but immediate intervention and initiation of cardiopulmonary resuscitation (CPR) and administration of an automated external defibrillator (AED) can increase chances of survival. It is not always possible for the emergency medical services (EMS) to reach OHCA cases quickly. As such, volunteers, including lay and professional responders (e.g. off-duty paramedics and fire-fighters), trained in CPR and AED use, are mobilised by the EMS to respond locally to prehospital medical emergencies (e.g. OHCA and stroke). This is known as community first response (CFR). Data on the impact of CFR interventions are limited. This research aims to identify the most important CFR data to collect and analyse, the most important uses of CFR data, as well as barriers and facilitators to data collection and use. This can inform policies to optimise the practice of CFR in Ireland. Methods: The nominal group technique (NGT) is a structured consensus process where key stakeholders (e.g. CFR volunteers, clinicians, EMS personnel, and patients/relatives) develop a set of prioritised recommendations. This study will employ the NGT, incorporating an online survey and online consensus meeting, to develop a priority list for the collection and use of CFR data in Ireland. Stakeholder responses will also identify barriers and facilitators to data collection and use, as well as indicators that improvements to these processes have been achieved. The maximum sample size for the NGT will be 20 participants to ensure sufficient representation from stakeholder groups. Discussion: This study, employing the NGT, will consult key stakeholders to establish CFR data collection, analysis, and use priorities. Results from this study will inform CFR research, practice, and policy, to improve the national CFR service model and inform international response programs.
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Affiliation(s)
- Dylan Keegan
- Discipline of General Practice, Clinical Science Institute, School of Medicine, National University of Ireland, Galway, Galway, H91 TK33, Ireland
| | - Eithne Heffernan
- Discipline of General Practice, Clinical Science Institute, School of Medicine, National University of Ireland, Galway, Galway, H91 TK33, Ireland
| | - Jenny McSharry
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Galway, H91 TK33, Ireland
| | - Tomás Barry
- School of Medicine, University College Dublin, Dublin 4, D04 V1W8, Ireland
| | - Siobhán Masterson
- Discipline of General Practice, Clinical Science Institute, School of Medicine, National University of Ireland, Galway, Galway, H91 TK33, Ireland
- National Ambulance Service, Health Service Executive, St. Eunan's Hall, St Conal's Hospital, Letterkenny, Donegal, F92 XK84, Ireland
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17
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Matinrad N, Reuter-Oppermann M. A review on initiatives for the management of daily medical emergencies prior to the arrival of emergency medical services. CENTRAL EUROPEAN JOURNAL OF OPERATIONS RESEARCH 2021; 30:251-302. [PMID: 34566490 PMCID: PMC8449697 DOI: 10.1007/s10100-021-00769-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/28/2021] [Indexed: 05/31/2023]
Abstract
Emergency services worldwide face increasing cost pressure that potentially limits their existing resources. In many countries, emergency services also face the issues of staff shortage-creating extra challenges and constraints, especially during crisis times such as the COVID-19 pandemic-as well as long distances to sparsely populated areas resulting in longer response times. To overcome these issues and potentially reduce consequences of daily (medical) emergencies, several countries, such as Sweden, Germany, and the Netherlands, have started initiatives using new types of human resources as well as equipment, which have not been part of the existing emergency systems before. These resources are employed in response to medical emergency cases if they can arrive earlier than emergency medical services (EMS). A good number of studies have investigated the use of these new types of resources in EMS systems, from medical, technical, and logistical perspectives as their study domains. Several review papers in the literature exist that focus on one or several of these new types of resources. However, to the best of our knowledge, no review paper that comprehensively considers all new types of resources in emergency medical response systems exists. We try to fill this gap by presenting a broad literature review of the studies focused on the different new types of resources, which are used prior to the arrival of EMS. Our objective is to present an application-based and methodological overview of these papers, to provide insights to this important field and to bring it to the attention of researchers as well as emergency managers and administrators.
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Affiliation(s)
- Niki Matinrad
- Department of Science and Technology, Linköping University, Norrköping, 60174 Sweden
| | - Melanie Reuter-Oppermann
- Information Systems - Software and Digital Business Group, Technical University of Darmstadt, 64289 Darmstadt, Germany
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18
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Kragh AR, Andelius L, Gregers MT, Kjølbye JS, Jørgensen AJ, Christensen AK, Zinckernagel L, Torp-Pedersen C, Folke F, Hansen CM. Immediate psychological impact on citizen responders dispatched through a mobile application to out-of-hospital cardiac arrests. Resusc Plus 2021; 7:100155. [PMID: 34430949 PMCID: PMC8371246 DOI: 10.1016/j.resplu.2021.100155] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/30/2021] [Accepted: 07/14/2021] [Indexed: 11/30/2022] Open
Abstract
Background Activating citizen responders may increase survival after out-of-hospital cardiac arrest (OHCA) but could induce significant psychological impact on the citizen responders. We examined psychological impact among citizen responders within the first days following resuscitation attempt. Methods and Results A mobile phone application to activate citizen responders to perform cardiopulmonary resuscitation (CPR) was implemented in the Capital Region of Denmark. All dispatched citizen responders (September 2017 to May 2019) received a survey 90 minutes after an alarm, including self-rating of perceived psychological impact on a scale of 1–4. Of 5,395 included citizen responders, most (88.6%) completed the survey within 24 hours. The majority reported no psychological impact (68.6%), whereas 24.7%, 5.5% and 1.2% reported low, moderate, or severe impact, respectively. Severe impact was more commonly reported in the following groups: No CPR training (3.8% vs 1.2%, p = 0.02), age < 30 years (2.0% vs 0.9%, p < 0.001), female sex (1.8% vs 0.7%, p < 0.001), provided CPR (2.7% vs 1.0%, p < 0.001), and arrived prior to the emergency medical services (EMS) (2.8% vs 0.7%, p < 0.001) compared to no to moderate impact. Chi square test, Mann-Whitney U test, Fischer’s exact test and a logistic regression model were used to assess differences in psychological impact across groups. Conclusion Very few citizen responders reported severe psychological impact. Lack of prior CPR training, younger age, female sex, performing CPR and arrival prior to the EMS were associated with greater psychological impact. Though very few citizen responders reported severe impact, the possibility of professional debriefing should be considered in citizen responder programs.
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Affiliation(s)
- Astrid Rolin Kragh
- Copenhagen Emergency Medical Services, University of Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Linn Andelius
- Copenhagen Emergency Medical Services, University of Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Mads Tofte Gregers
- Copenhagen Emergency Medical Services, University of Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Julie Samsøe Kjølbye
- Copenhagen Emergency Medical Services, University of Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anne Juul Jørgensen
- Copenhagen Emergency Medical Services, University of Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Line Zinckernagel
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Christian Torp-Pedersen
- Department of Cardiology, Aalborg University Hospital, Denmark.,Department of Cardiology, North Zealand Hospital, Denmark
| | - Fredrik Folke
- Copenhagen Emergency Medical Services, University of Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiology, Herlev Gentofte University Hospital, Copenhagen, Denmark
| | - Carolina Malta Hansen
- Copenhagen Emergency Medical Services, University of Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiology, Herlev Gentofte University Hospital, Copenhagen, Denmark
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19
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Jellestad ASL, Folke F, Molin R, Lyngby RM, Hansen CM, Andelius L. Collaboration between emergency physicians and citizen responders in out-of-hospital cardiac arrest resuscitation. Scand J Trauma Resusc Emerg Med 2021; 29:110. [PMID: 34344415 PMCID: PMC8330065 DOI: 10.1186/s13049-021-00927-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 07/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Citizen responder programmes dispatch volunteer citizens to initiate resuscitation in nearby out-of-hospital cardiac arrests (OHCA) before the Emergency Medical Services (EMS) arrival. Little is known about the interaction between citizen responders and EMS personnel during the resuscitation attempt. In the Capital Region of Denmark, emergency physicians are dispatched to all suspected OHCAs. The aim of this study was to evaluate how emergency physicians perceived the collaboration with citizen responders during resuscitation attempts. METHOD This cross-sectional study was conducted through an online questionnaire. It included all 65 emergency physicians at Copenhagen EMS between June 9 and December 13, 2019 (catchment area 1.8 million). The questionnaire examined how emergency physicians perceived the interaction with citizen responders at the scene of OHCA (use of citizen responders before and after EMS arrival, citizen responders' skills in cardiopulmonary resuscitation (CPR), and challenges in this setting). RESULTS The response rate was 87.7% (57/65). Nearly all emergency physicians (93.0%) had interacted with a citizen responder at least once. Of those 92.5%(n = 49) considered it relevant to activate citizen responders to OHCA resuscitation, and 67.9%(n = 36) reported the collaboration as helpful. When citizen responders arrived before EMS, 75.5%(n = 40) of the physicians continued to use citizen responders to assist with CPR or to carry equipment. Most (84.9%, n = 45) stated that citizen responders had the necessary skills to perform CPR. Challenges in the collaboration were described by 20.7%(n = 11) of the emergency physicians and included citizen responders being mistaken for relatives, time-consuming communication, or crowding problems during resuscitation. CONCLUSION Emergency physicians perceived the collaboration with citizen responders as valuable, not only for delivery of CPR, but were also considered an extra helpful resource providing non-CPR related tasks such as directing the EMS to the arrest location, carrying equipment and taking care of relatives.
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Affiliation(s)
- Anne-Sofie Linde Jellestad
- Copenhagen Emergency Medical Services, University of Copenhagen, Telegrafvej 5, opgang 2, 3. sal, 2750, Ballerup, Denmark. .,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Fredrik Folke
- Copenhagen Emergency Medical Services, University of Copenhagen, Telegrafvej 5, opgang 2, 3. sal, 2750, Ballerup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiology, Herlev-Gentofte University Hospital, Copenhagen, Denmark
| | - Rune Molin
- Copenhagen Emergency Medical Services, University of Copenhagen, Telegrafvej 5, opgang 2, 3. sal, 2750, Ballerup, Denmark
| | - Rasmus Meyer Lyngby
- Copenhagen Emergency Medical Services, University of Copenhagen, Telegrafvej 5, opgang 2, 3. sal, 2750, Ballerup, Denmark.,Kingston University and St. Georges, University of London, London, UK
| | - Carolina Malta Hansen
- Copenhagen Emergency Medical Services, University of Copenhagen, Telegrafvej 5, opgang 2, 3. sal, 2750, Ballerup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiology, Herlev-Gentofte University Hospital, Copenhagen, Denmark
| | - Linn Andelius
- Copenhagen Emergency Medical Services, University of Copenhagen, Telegrafvej 5, opgang 2, 3. sal, 2750, Ballerup, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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20
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Keegan D, Heffernan E, McSharry J, Barry T, Masterson S. Identifying priorities for the collection and use of data related to community first response and out-of-hospital cardiac arrest: protocol for a nominal group technique study. HRB Open Res 2021; 4:81. [PMID: 34909578 PMCID: PMC8637246 DOI: 10.12688/hrbopenres.13347.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 04/05/2024] Open
Abstract
Introduction: Out-of-hospital cardiac arrest (OHCA) is a devastating health event that affects over 2000 people each year in Ireland. Survival rate is low, but immediate intervention and initiation of cardiopulmonary resuscitation (CPR) and administration of an automated external defibrillator (AED) can increase chances of survival. It is not always possible for the emergency medical services (EMS) to reach OHCA cases quickly. As such, volunteers, including lay and professional responders (e.g. off-duty paramedics and fire-fighters), trained in CPR and AED use, are mobilised by the EMS to respond locally to prehospital medical emergencies (e.g. OHCA and stroke). This is known as community first response (CFR). Data on the impact of CFR interventions are limited. This research aims to identify the most important CFR data to collect and analyse, the most important uses of CFR data, as well as barriers and facilitators to data collection and use. This can inform policies to optimise the practice of CFR in Ireland. Methods: The nominal group technique (NGT) is a structured consensus process where key stakeholders (e.g. CFR volunteers, clinicians, EMS personnel, and patients/relatives) develop a set of prioritised recommendations. This study will employ the NGT, incorporating an online survey and online consensus meeting, to develop a priority list for the collection and use of CFR data in Ireland. Stakeholder responses will also identify barriers and facilitators to data collection and use, as well as indicators that improvements to these processes have been achieved. The maximum sample size for the NGT will be 20 participants to ensure sufficient representation from stakeholder groups. Discussion: This study, employing the NGT, will consult key stakeholders to establish CFR data collection, analysis, and use priorities. Results from this study will inform CFR research, practice, and policy, to improve the national CFR service model and inform international response programs.
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Affiliation(s)
- Dylan Keegan
- Discipline of General Practice, Clinical Science Institute, School of Medicine, National University of Ireland, Galway, Galway, H91 TK33, Ireland
| | - Eithne Heffernan
- Discipline of General Practice, Clinical Science Institute, School of Medicine, National University of Ireland, Galway, Galway, H91 TK33, Ireland
| | - Jenny McSharry
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Galway, H91 TK33, Ireland
| | - Tomás Barry
- School of Medicine, University College Dublin, Dublin 4, D04 V1W8, Ireland
| | - Siobhán Masterson
- Discipline of General Practice, Clinical Science Institute, School of Medicine, National University of Ireland, Galway, Galway, H91 TK33, Ireland
- National Ambulance Service, Health Service Executive, St. Eunan's Hall, St Conal's Hospital, Letterkenny, Donegal, F92 XK84, Ireland
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Barry T, Headon M, Quinn M, Egan M, Masterson S, Deasy C, Bury G. General practice and cardiac arrest community first response in Ireland. Resusc Plus 2021; 6:100127. [PMID: 34223384 PMCID: PMC8244493 DOI: 10.1016/j.resplu.2021.100127] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 11/21/2022] Open
Abstract
Background In Ireland, the MERIT 3 scheme enables doctors to volunteer as cardiac arrest community first responders and receive text message alerts from emergency medical services (EMS) to facilitate early care. Aim To establish the sustainability, systems and clinical outcomes of a novel, general practice based, cardiac arrest first response initiative over a four-year period. Methods Data on alerts, responses, incidents and outcomes were gathered prospectively using EMS control data, incident data reported by responders and corroborative data from the national Out-of-Hospital Cardiac Arrest Registry. Results Over the period 2016–2019, 196 doctors joined MERIT 3 and 163 (83.2%) were alerted on one or more occasions; 61.3% of those alerted responded to at least one alert. Volunteer doctors attended 300 patients of which 184 (61.3%) had suffered OHCA and had a resuscitation attempt. Responders arrived to OHCA before EMS on 75 occasions (40.8%), initiated chest compressions on seven occasions (3.8%), and brought the first defibrillator on 42 occasions (22.8%). Information on the first monitored rhythm was available for 149/184 (81.0%) patients and was shockable in 30/149 (20.1%); in 9/30 cases, shocks were administered by responders. The overall survival rate was 11.0% (national survival rate 7.3%). Doctors also provided advanced life support and were closely involved in decision making on ceasing resuscitation. Conclusion The MERIT 3 initiative in Ireland has been sustained over a four-year period and has demonstrated the ability of volunteer doctors to provide early care for OHCA patients as well as more complex interventions including end-of-life care. Further development of this strategy is warranted.
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Affiliation(s)
- Tomas Barry
- School of Medicine, University College Dublin, Ireland
- Corresponding author.
| | - Mary Headon
- Centre for Emergency Medical Science, University College Dublin, Ireland
| | | | - Mairead Egan
- Centre for Emergency Medical Science, University College Dublin, Ireland
| | - Siobhan Masterson
- Clinical Strategy and Evaluation, National Ambulance Service, Health Service Executive, Ireland
| | | | - Gerard Bury
- School of Medicine, University College Dublin, Ireland
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Heffernan E, Mc Sharry J, Murphy A, Barry T, Deasy C, Menzies D, Masterson S. Community first response and out-of-hospital cardiac arrest: a qualitative study of the views and experiences of international experts. BMJ Open 2021; 11:e042307. [PMID: 33757945 PMCID: PMC7993284 DOI: 10.1136/bmjopen-2020-042307] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES This research aimed to examine the perspectives, experiences and practices of international experts in community first response: an intervention that entails the mobilisation of volunteers by the emergency medical services to respond to prehospital medical emergencies, particularly cardiac arrests, in their locality. DESIGN This was a qualitative study in which semistructured interviews were conducted via teleconferencing. The data were analysed in accordance with an established thematic analysis procedure. SETTING There were participants from 11 countries: UK, USA, Canada, Australia, New Zealand, Singapore, Ireland, Norway, Sweden, Denmark and the Netherlands. PARTICIPANTS Sixteen individuals who held academic, clinical or managerial roles in the field of community first response were recruited. Maximum variation sampling targeted individuals who varied in terms of gender, occupation and country of employment. There were eight men and eight women. They included ambulance service chief executives, community first response programme managers and cardiac arrest registry managers. RESULTS The findings provided insights on motivating and supporting community first response volunteers, as well as the impact of this intervention. First, volunteers can be motivated by 'bottom-up factors', particularly their characteristics or past experiences, as well as 'top-down factors', including culture and legislation. Second, providing ongoing support, especially feedback and psychological services, is considered important for maintaining volunteer well-being and engagement. Third, community first response can have a beneficial impact that extends not only to patients but also to their family, their community and to the volunteers themselves. CONCLUSIONS The findings can inform the future development of community first response programmes, especially in terms of volunteer recruitment, training and support. The results also have implications for future research by highlighting that this intervention has important outcomes, beyond response times and patient survival, which should be measured, including the benefits for families, communities and volunteers.
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Affiliation(s)
- Eithne Heffernan
- Discipline of General Practice, Clinical Science Institute, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Jenny Mc Sharry
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Andrew Murphy
- Discipline of General Practice, Clinical Science Institute, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Tomás Barry
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Conor Deasy
- Department of Emergency Medicine, Cork University Hospital, Cork, Ireland
- National Ambulance Service, Health Service Executive, Dublin, Ireland
| | - David Menzies
- National Ambulance Service, Health Service Executive, Dublin, Ireland
- St Vincent's University Hospital, Dublin, Ireland
- CFR Ireland, Dublin, Ireland
| | - Siobhan Masterson
- Discipline of General Practice, Clinical Science Institute, School of Medicine, National University of Ireland Galway, Galway, Ireland
- National Ambulance Service, Health Service Executive, Dublin, Ireland
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Suppan L, Herren T, Taramarcaz V, Regard S, Martin-Achard S, Zamberg I, Larribau R, Niquille M, Mach F, Suppan M, Schiffer E. A Short Intervention Followed by an Interactive E-Learning Module to Motivate Medical Students to Enlist as First Responders: Protocol for a Prospective Implementation Study. JMIR Res Protoc 2020; 9:e24664. [PMID: 33155574 PMCID: PMC7679213 DOI: 10.2196/24664] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND In Geneva, Switzerland, basic life support (BLS) maneuvers are provided in only 40% of out-of-hospital cardiac arrests (OHCAs) cases. As OHCA outcomes are markedly improved when BLS maneuvers are swiftly applied, a "first-responder" system was introduced in 2019. When emergency dispatchers identify a possible OHCA, first responders receive an alert message on a specific app (Save-a-Life) installed on their smartphones. Those nearest to the victim and immediately available are sent the exact location of the intervention. First-year medical students only have limited knowledge regarding BLS procedures but might nevertheless need to take care of OHCA victims. Medical students responding to out-of-hospital emergencies are off-duty in half of these situations, and offering junior medical students the opportunity to enlist as first responders might therefore not only improve OHCA outcomes but also foster a greater recognition of the role medical students can hold in our society. OBJECTIVE Our aim is to determine whether providing first-year medical students with a short intervention followed by an interactive e-learning module can motivate them to enlist as first responders. METHODS After obtaining the approval of the regional ethics committee and of the vice-dean for undergraduate education of the University of Geneva Faculty of Medicine (UGFM), 2 senior medical students will present the project to their first-year colleagues at the beginning of a lecture. First-year students will then be provided with a link to an interactive e-learning module which has been designed according to the Swiss Resuscitation Council's first aid guidelines. After answering a first questionnaire and completing the module, students will be able to register for practice sessions. Those attending and successfully completing these sessions will receive a training certificate which will enable them to enlist as first responders. The primary outcome will be the proportion of first-year medical students enlisting as first responders at the end of the study period. Secondary outcomes will be the proportion of first-year medical students electing to register on the platform, to begin the e-learning module, to complete the e-learning module, to register for practice sessions, to attend the practice sessions, and to obtain a certificate. The reasons given by medical students for refusing to participate will be analyzed. We will also assess how comfortable junior medical students would feel to be integrated into the first responders system at the end of the training program and whether it affects the registration rate. RESULTS The regional ethics committee (Req-2020-01143) and the UGFM vice-dean for undergraduate education have given their approval to the realization of this study, which is scheduled to begin in January 2021. CONCLUSIONS This study should determine whether a short intervention followed by an interactive e-learning module can motivate first-year medical students to enlist as first responders. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/24664.
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Affiliation(s)
- Laurent Suppan
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Tara Herren
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Victor Taramarcaz
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Simon Regard
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | | | - Ido Zamberg
- Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
- Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- School of Education, Johns Hopkins University, Baltimore, MD, United States
| | - Robert Larribau
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Marc Niquille
- Division of Emergency Medicine, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Francois Mach
- Cardiology Department, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Mélanie Suppan
- Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Eduardo Schiffer
- Division of Anesthesiology, Department of Anesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
- Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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24
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Out-of-hospital cardiac arrest: comparing organised groups to individual first responders. Eur J Anaesthesiol 2020; 38:1096-1104. [DOI: 10.1097/eja.0000000000001335] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Heffernan E, Oving I, Barry T, Phung VH, Siriwardena AN, Masterson S. Factors that motivate individuals to volunteer to be dispatched as first responders in the event of a medical emergency: A systematic review protocol. HRB Open Res 2020; 2:34. [PMID: 32490350 PMCID: PMC7236422 DOI: 10.12688/hrbopenres.12969.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Voluntary First Response is an important component of prehospital care for medical emergencies, particularly cardiac arrest, in many countries. This intervention entails the mobilisation of volunteers, known as Community First Responders (CFRs), by the Emergency Medical Services to respond to medical emergencies in their locality. They include lay responders and/or professional responders (e.g. police officers, fire fighters, and general practitioners). A wide variety of factors are thought to motivate CFRs to join and remain engaged in Voluntary First Response schemes, such as the availability of learning opportunities, recognition, counselling, and leadership. The aim of this review is to develop an in-depth understanding of CFR motivation, including the factors that influence the initial decision to volunteer as a CFR and the factors that sustain involvement in Voluntary First Response over time. Any factors relevant to CFR de-motivation and turnover will also be examined. Methods: This is a protocol for a qualitative systematic review of the factors that influence the motivation of individuals to participate in Voluntary First Response. A systematic search will be carried out on seven electronic databases. Qualitative studies, mixed-methods studies, and any other studies producing data relating to the review question will be eligible for inclusion. Title and abstract screening, as well as full text screening, will be completed independently by two authors. A narrative synthesis, which is an established qualitative synthesis methodology, will be performed. The quality of each of the included studies will be critically appraised. Discussion: The findings of this review will be used to optimise the intervention of Voluntary First Response. Specifically, the results will inform the design and organisation of Voluntary First Response schemes, including their recruitment, training, and psychological support processes. This could benefit a range of stakeholders, including CFRs, paramedics, emergency physicians, patients, and the public.
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Affiliation(s)
- Eithne Heffernan
- Discipline of General Practice, Clinical Science Institute, School of Medicine, National University of Ireland, Galway, H91 TK33, Ireland
| | - Iris Oving
- Department of Clinical and Experimental Cardiology, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, 1012 WX, The Netherlands
| | - Tomás Barry
- School of Medicine, University College Dublin, Dublin 4, D04 V1W8, Ireland
| | - Viet-Hai Phung
- Community and Health Research Unit, School of Health and Social Care, Sarah Swift Building, University of Lincoln, Lincoln, LN5 7AT, UK
| | - Aloysius Niroshan Siriwardena
- Community and Health Research Unit, School of Health and Social Care, Sarah Swift Building, University of Lincoln, Lincoln, LN5 7AT, UK
| | - Siobhán Masterson
- Discipline of General Practice, Clinical Science Institute, School of Medicine, National University of Ireland, Galway, H91 TK33, Ireland
- National Ambulance Service, Health Service Executive, St. Eunan's Hall, St Conal's Hospital, Letterkenny, Donegal, F92 XK84, Ireland
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Heffernan E, Oving I, Barry T, Phung VH, Siriwardena AN, Masterson S. Factors that motivate individuals to volunteer to be dispatched as first responders in the event of a medical emergency: A systematic review protocol. HRB Open Res 2019; 2:34. [PMID: 32490350 PMCID: PMC7236422 DOI: 10.12688/hrbopenres.12969.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2019] [Indexed: 01/21/2024] Open
Abstract
Background: Voluntary First Response is an important component of prehospital care for medical emergencies, particularly cardiac arrest, in many countries. This intervention entails the mobilisation of volunteers, known as Community First Responders (CFRs), by the Emergency Medical Services to respond to medical emergencies in their locality. They include lay responders and/or professional responders (e.g. police officers, fire fighters, and general practitioners). A wide variety of factors are thought to motivate CFRs to join and remain engaged in Voluntary First Response schemes, such as the availability of learning opportunities, recognition, counselling, and leadership. The aim of this review is to develop an in-depth understanding of CFR motivation, including the factors that influence the initial decision to volunteer as a CFR and the factors that sustain involvement in Voluntary First Response over time. Any factors relevant to CFR de-motivation and turnover will also be examined. Methods: This is a protocol for a qualitative systematic review of the factors that influence the motivation of individuals to participate in Voluntary First Response. A systematic search will be carried out on seven electronic databases. Qualitative studies, mixed-methods studies, and any other studies producing data relating to the review question will be eligible for inclusion. Title and abstract screening, as well as full text screening, will be completed independently by two authors. A narrative synthesis, which is an established qualitative synthesis methodology, will be performed. The quality of each of the included studies will be critically appraised. Discussion: The findings of this review will be used to optimise the intervention of Voluntary First Response. Specifically, the results will inform the design and organisation of Voluntary First Response schemes, including their recruitment, training, and psychological support processes. This could benefit a range of stakeholders, including CFRs, paramedics, emergency physicians, patients, and the public.
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Affiliation(s)
- Eithne Heffernan
- Discipline of General Practice, Clinical Science Institute, School of Medicine, National University of Ireland, Galway, H91 TK33, Ireland
| | - Iris Oving
- Department of Clinical and Experimental Cardiology, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam, 1012 WX, The Netherlands
| | - Tomás Barry
- School of Medicine, University College Dublin, Dublin 4, D04 V1W8, Ireland
| | - Viet-Hai Phung
- Community and Health Research Unit, School of Health and Social Care, Sarah Swift Building, University of Lincoln, Lincoln, LN5 7AT, UK
| | - Aloysius Niroshan Siriwardena
- Community and Health Research Unit, School of Health and Social Care, Sarah Swift Building, University of Lincoln, Lincoln, LN5 7AT, UK
| | - Siobhán Masterson
- Discipline of General Practice, Clinical Science Institute, School of Medicine, National University of Ireland, Galway, H91 TK33, Ireland
- National Ambulance Service, Health Service Executive, St. Eunan's Hall, St Conal's Hospital, Letterkenny, Donegal, F92 XK84, Ireland
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