Mobile phone-based alerting of CPR-trained volunteers simultaneously with the ambulance can reduce the resuscitation-free interval and improve outcome after out-of-hospital cardiac arrest: A German, population-based cohort study

Stroop, Ralf; Kerner, Thoralf; Strickmann, Bernd; Hensel, M.

doi:10.1016/j.resuscitation.2019.12.012

Cited by 65 publications

(66 citation statements)

References 33 publications

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“…This conclusion is supported by the current literature (28-30, 16, 24). A recent study revealed higher hospital discharge rate as well as improved neurological outcome in patients treated by CFR dispatched by SBA (31).…”

Section: Discussionmentioning

confidence: 98%

Smartphone-based dispatch of Community First Responders to Out-of-Hospital Cardiac Arrest - Statements from an International Consensus Conference

Metelmann

Kohnen³

et al. 2020

Preprint

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Background: Over the past decade Smartphone-based activation (SBA) of Community First Responders (CFR) to out-of-hospital cardiac arrests (OHCA) has gained much attention and popularity throughout Europe. Various programmes have been established, and interestingly there are considerable differences in technology, responder spectrum and the degree of integration into the prehospital emergency services. It is unclear whether these dissimilarities affect outcome. This consensus paper reviews the current state in Europe, reveals similarities and controversies, and aims to help aligning future strategies for SBA of CFR in Europe.Methods: In a consensus conference a three-step approach was used: (i) presentation of current research from five European countries; (ii) workshops discussing evidence amongst the audience to generate consensus statements; (iii) anonymous real-time voting applying the modified RAND-UCLA methodology to adopt or reject the statements. The consensus panel aimed to represent all stakeholders involved in this topic.Results: While 21 of 25 generated statements gained approval, consensus was only found for 5 of them. One statement was rejected but without consensus. Members of the consensus conference confirmed that CFR save lives. They further acknowledged the crucial role of emergency medical control centres and called for nationwide strategies. Conclusions: Smartphone-based alert of CFR to OHCA saves lives. The statement generated by the consensus conference help to advise the public, healthcare services and governments to utilise these systems to their full potential, and direct the research community towards fields that still need to be addressed.

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Section: Discussionmentioning

confidence: 98%

Smartphone-based dispatch of Community First Responders to Out-of-Hospital Cardiac Arrest - Statements from an International Consensus Conference

Metelmann

Kohnen³

et al. 2020

Preprint

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“…For the critical outcome of survival with favorable neurological outcome at discharge, we identified very low-certainty evidence from 2 observational studies (downgraded for serious risk of bias) enrolling 2149 OHCAs showing no benefit for having a citizen CPR responder notified of the event via technology or social media (adjusted pooled RR, 1.4; 95% CI, 0.6À3.4). 344,349 For the critical outcome of survival to hospital discharge/30-day survival, we identified moderate-certainty evidence from 1 RCT (downgraded for serious risk of bias) 348 and very low-certainty evidence (downgraded for serious risk of bias and serious inconsistency) from 4 observational studies. 344,346,349,350 The RCT reported no benefit in 1-month survival between the intervention and the control group (unadjusted RR, 1.3; 95% CI, 0.8À2.1).…”

Section: Consensus On Sciencementioning

confidence: 99%

“…344,349 For the critical outcome of survival to hospital discharge/30-day survival, we identified moderate-certainty evidence from 1 RCT (downgraded for serious risk of bias) 348 and very low-certainty evidence (downgraded for serious risk of bias and serious inconsistency) from 4 observational studies. 344,346,349,350 The RCT reported no benefit in 1-month survival between the intervention and the control group (unadjusted RR, 1.3; 95% CI, 0.8À2.1). The metaanalysis of adjusted data included 2905 OHCAs (4 studies) and showed benefit in survival to hospital discharge when a citizen CPR responder was notified of the event by a smartphone app with MPS or TM-alert system (adjusted pooled RR, 1.70; 95% CI, 1.16À2.48; I 2 = 69%; P = 0.02); 98/1000 more patients benefitted with the intervention (95% CI, 22 more patients/1000 to 208 more patients/ 1000 when compared with notification by a smartphone app with MPS or TM-alert system not being offered).…”

Section: Consensus On Sciencementioning

confidence: 99%

“…These results are confirmed by RRs reported separately in 3 of the 4 studies, showing benefit in survival to hospital discharge when a citizen CPR responder was notified by technology (RR, 1.7 [95% CI, 1.17À2. 349 ). One of the studies did not report any significant benefit (RR, 1.06; 95% CI, 0.72 À1.51).…”

Section: Consensus On Sciencementioning

confidence: 99%

“…348 We also identified very low-certainty evidence (downgraded for serious risk of bias) from 3 observational cohort studies enrolling 2571 OHCAs showing no benefit for having a citizen CPR responder notified of the event via technology or social media (unadjusted pooled RR, 0.97; 95% CI, 0.60À1.57). 344,346,349 For the important outcome of bystander CPR, we identified highcertainty evidence from 1 RCT. 348 This RCT enrolled 667 OHCAs, showing an absolute difference for intervention versus control of 14 percentage points (6 higher to 21 higher; adjusted RR, 1.27; 95% CI, 1.10À1.46); 129/1000 more patients benefitted with the intervention (95% CI, 48 more patients/1000 to 219 more patients/1000 when compared with notification by a smartphone app with MPS or TM-alert system not being offered).…”

Section: Consensus On Sciencementioning

confidence: 99%

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Education, Implementation, and Teams

Greif¹,

Bhanji²,

Bigham³

et al. 2020

Resuscitation

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Addressing out‐of‐hospital cardiac arrest with current technology advances: Breaking the deadlock with a mobile network

Hayashi,

Iwasaki

2024

Journal of Arrhythmia

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Out‐of‐hospital cardiac arrest (OHCA) is a global public health problem, with survival rates remaining low at around 10% or less despite widespread cardiopulmonary resuscitation (CPR) training and availability of automated external defibrillators (AEDs). This is partly due to the challenges of knowing when and where a sudden OHCA occurs and where the nearest AED is located. In response, countries around the world have begun to use network technology‐based smartphone applications. These applications are activated by emergency medical service dispatchers and alert preregistered volunteer first responders (VFRs) to nearby OHCAs using Global Positioning System localization. Accumulating evidence, although mostly from observational studies, shows their effectiveness in increasing the rate of bystander CPR, defibrillation, and patient survival. Current guidelines recommend the use of these VFR alerting systems, and the results of ongoing randomized trials are awaited for further dissemination. This article also proposed the concept of a life‐saving mobile network (LMN), which uses opportunistic network and wireless sensor network technologies to create a dynamic mesh network of potential victims, rescuers, and defibrillators. The LMN works by detecting a fatal arrhythmia with a wearable sensor device, localizing the victim and the nearest AED with nearby smartphones, and notifying VFRs through peer‐to‐peer communication. While there are challenges and limitations to implementing the LMN in society, this innovative network technology would reduce the tragedy of sudden cardiac death from OHCA.

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Mobile phone-based alerting of CPR-trained volunteers simultaneously with the ambulance can reduce the resuscitation-free interval and improve outcome after out-of-hospital cardiac arrest: A German, population-based cohort study

Cited by 65 publications

References 33 publications

Smartphone-based dispatch of Community First Responders to Out-of-Hospital Cardiac Arrest - Statements from an International Consensus Conference

Smartphone-based dispatch of Community First Responders to Out-of-Hospital Cardiac Arrest - Statements from an International Consensus Conference

Education, Implementation, and Teams

Addressing out‐of‐hospital cardiac arrest with current technology advances: Breaking the deadlock with a mobile network

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