A quantitative assessment of the contribution of “citizen First Responder” in the adult out-of-hospital chain of survival during COVID-19 pandemic

Abstract

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Cardiac arrest and coronavirus disease 2019

“…The reasons for that are probably the same of the reduction of bystanders CPR. It should also be considered that during pandemic, especially during the first pandemic wave, many first responder (FR) systems were suspended or restricted to some FR categories [ 49 ▪ , 50 ▪ ], probably contributing to the decrease in CPR and AED use before EMS. Beyond the intervention by bystanders and first responders, also the EMS intervention was affected by the outbreak.…”

The Automated External Defibrillator: Heterogeneity of Legislation, Mapping and Use across Europe. New Insights from the ENSURE Study

“…Furthermore, a crucial role in enhancing the possibility of providing early defibrillation is played by FRs [6,25,[32][33][34]. FRs are commonly divided into "professional FRs" such as police officers, firefighters or off-duty medical personnel and "citizen FRs" meaning trained lay persons [7]. For this latter category, the only chance of using an AED depends on the availability of an AED on site and the possibility of receiving instructions from the dispatch center (or by the alerting APP) about the closest AED, stressing once again the importance of AED mapping.…”

“…Early defibrillation increases not only the rate of return of spontaneous circulation (ROSC) and survival but also a favorable neurological outcome at the hospital discharge, irrespective of it being a witnessed event, bystander CPR or an initial rhythm [3][4][5]. AED use by a bystander or first responders (FRs; i.e., police officers, firefighters, off-duty medical personnel and trained lay persons alerted when a patient experiences an OHCA nearby) before the arrival of emergency medical service (EMS) personnel is of a primary importance particularly when considering that the earlier the defibrillation, the higher the chance of survival [6][7][8]. This concept was proven in the early 2000s, when the public-access defibrillation (PAD) trial was carried out in the USA involving security officers after cardiac arrests in casinos [9] and has been continuously reinforced by numerous scientific publications subsequently released [10,11].…”

Clinical update on COVID-19 for the emergency clinician: Cardiac arrest in the out-of-hospital and in-hospital settings

“…For OHCA, the incidence of OHCA has increased while survival rates have declined commensurately with COVID-19 in several studies, which may be due to several important factors [ 11 , [22] , [23] , [24] , [25] , [26] ]. Due to concerns of viral spread, bystanders may be less willing to intervene in OHCA [ [27] , [28] , [29] , [30] ]. Because of social distancing and quarantines, the likelihood of a witnessed arrest occurring in public, with a knowledgeable bystander capable of performing CPR and/or applying an automated external defibrillator (AED) may have decreased [ 30 ].…”