Showing papers on "First responder published in 2022"

Understanding the Importance of the Lay Responder Experience in Out-of-Hospital Cardiac Arrest: A Scientific Statement From the American Heart Association

Abstract: Bystander cardiopulmonary resuscitation (CPR) is critical to increasing survival from out-of-hospital cardiac arrest. However, the percentage of cases in which an individual receives bystander CPR is actually low, at only 35% to 40% globally. Preparing lay responders to recognize the signs of sudden cardiac arrest, call 9-1-1, and perform CPR in public and private locations is crucial to increasing survival from this public health problem. The objective of this scientific statement is to summarize the most recent published evidence about the lay responder experience of training, responding, and dealing with the residual impact of witnessing an out-of-hospital cardiac arrest. The scientific statement focuses on the experience-based literature of actual responders, which includes barriers to responding, experiences of doing CPR, use of an automated external defibrillator, the impact of dispatcher-assisted CPR, and the potential for postevent psychological sequelae. The large body of qualitative and observational studies identifies several gaps in crucial knowledge that, if targeted, could increase the likelihood that those who are trained in CPR will act. We suggest using the experience of actual responders to inform more contextualized training, including the implications of performing CPR on a family member, dispelling myths about harm, training and litigation, and recognition of the potential for psychologic sequelae after the event.

Work-related traumatic stress spillover in first responder families: A systematic review of the literature.

Abstract: The aim of the current review was to examine the impact of trauma exposure on first responder families, particularly, in terms of their relationships, family roles and obligations, and engagement in risk factors.Using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRIMSA) guidelines, 3,213 articles were screened, and 16 studies met inclusion for the current review. A risk of bias assessment was conducted to determine the methodological rigor of included studies and data was extracted to highlight the research questions, targeted populations, study design, measurement instruments, and outcomes of the included studies.The majority of research questions were asked to understand the experience of being a spouse to a first responder and to identify the stressors, supports, and resources of first responders and their families. Additionally, studies in this area were determined to be conducted primarily with spouses or partners of first responders, utilizing predominantley cross-sectional methodologies and measurement instruments with good psychometric properties.A discussion of the limitations and gaps in the literature was included and generally highlighted a lack of diversity in sample demographic characteristics and study design. Five concrete recommendations for future research were made to address limitations and strengthen research in this area. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A Short Intervention and an Interactive e-Learning Module to Motivate Medical and Dental Students to Enlist as First Responders: Implementation Study

Abstract: Background Prompt and proficient basic life support (BLS) maneuvers are essential to increasing the odds of survival after out-of-hospital cardiac arrest. However, significant time can elapse before the arrival of professional rescuers. To decrease these delays, many countries have developed first responder networks. These networks are composed of BLS-certified lay or professional rescuers who can be dispatched by emergency medical communication centers to take care of those who experience out-of-hospital cardiac arrest. Many systems are, however, limited by a relatively low number of active first responders, and first-year medical and dental students may represent an almost untapped pool of potential rescuers. On top of providing an enhanced BLS coverage to the population, this could also help medical students be better prepared to their future role as certified health care providers and address societal expectations regarding health care students. Objective Our objective was to describe the impact of a short motivational intervention followed by a blended BLS course (e-learning and practice session) designed to motivate first-year medical and dental students to enlist as first responders. Methods A short, web-based, motivational intervention presenting this project took place, and first-year University of Geneva, Faculty of Medicine students were provided with a link to the study platform. Those who agreed to participate were redirected to a demographic questionnaire before registering on the platform. The participants were then asked to answer a second questionnaire designed to determine their baseline knowledge prior to following an interactive e-learning module. Upon completion, a web-based booking form enabling them to register for a 1-hour practice session was displayed. These sessions were held by senior medical students who had been trained and certified as BLS instructors. The participants who attended these practice sessions were asked to answer a postcourse questionnaire before receiving the certificate enabling them to register as first responders. Results Out of the 529 first-year students registered at University of Geneva, Faculty of Medicine on January 14, 2021, 190 (35.9%) initially agreed to participate. Moreover, 102 (19.3%) attended the practice sessions, and 48 (9.1%) had completed all training and enlisted as first responders on the dedicated platform, Save a Life, at 6 months (July 14, 2021). Postcourse confidence in resuscitation skills was associated with a higher likelihood of registering as first responder (P=.03). No association was found between prior BLS knowledge and the probability of registering to a practice session (P=.59), of obtaining a course completion certificate (P=.29), or of enlisting as first responder (P=.56). Conclusions This study shows that a motivational intervention associated with a short BLS course can convince medical students to enlist as first responders. Further studies are needed to understand the rather low proportion of medical students finally registering as first responders. International Registered Report Identifier (IRRID) RR2-10.2196/24664

Activation of Citizen Responders to Out‐of‐Hospital Cardiac Arrest During the COVID‐19 Outbreak in Denmark 2020

Abstract: Background Little is known about how COVID-19 influenced engagement of citizen responders dispatched to out-of-hospital cardiac arrest (OHCA) by a smartphone application. The objective was to describe and analyze the Danish Citizen Responder Program and bystander interventions (both citizen responders and nondispatched bystanders) during the first COVID-19 lockdown in 2020. Methods and Results All OHCAs from January 1, 2020, to June 30, 2020, with citizen responder activation in 2 regions of Denmark were included. We compared citizen responder engagement for OHCA in the nonlockdown period (January 1, 2020, to March 10, 2020, and April 21, 2020, to June 30, 2020) with the lockdown period (March 11, 2020, to April 20, 2020). Data are displayed in the order lockdown versus nonlockdown period. Bystander cardiopulmonary resuscitation rates did not differ in the 2 periods (99% versus 92%; P=0.07). Bystander defibrillation (9% versus 14%; P=0.4) or return-of-spontaneous circulation (23% versus 23%; P=1.0) also did not differ. A similar amount of citizen responders accepted alarms during the lockdown (6 per alarm; interquartile range, 6) compared with the nonlockdown period (5 per alarm; interquartile range, 5) (P=0.05). More citizen responders reported performing chest-compression-only cardiopulmonary resuscitation during lockdown compared with nonlockdown (79% versus 59%; P=0.0029), whereas fewer performed standardized cardiopulmonary resuscitation, including ventilations (19% versus 38%; P=0.0061). Finally, during lockdown, more citizen responders reported being not psychologically affected by attending an OHCA compared with nonlockdown period (68% versus 56%; P<0.0001). Likewise, fewer reported being mildly affected during lockdown (26%) compared with nonlockdown (35%) (P=0.003). Conclusions The COVID-19 lockdown in Denmark was not associated with decreased bystander-initiated resuscitation in OHCAs attended by citizen responders.

Community First Aid Training for Disaster Preparedness: A Review of Education Content

Abstract: Disasters pose a substantial risk to people’s health and well-being on a global scale. Community-based training on the initial response to traffic accidents has a considerable impact on reducing morbidity and mortality. There is no information on the most effective type of community-based training for such incidents or on how to integrate this into disaster response. The goal of this study was to characterize the content of first aid training and its effect on providing assistance during a disaster. The MEDLINE, PsycINFO, Scopus, and Web of Science databases were searched. The terms ”basic life support” OR ”bleed control” OR ”cardiopulmonary resuscitation (CPR)” OR ”first aid” AND ”bystander” OR ”layperson” OR ”public” were used. We chose the general public as our sample. We included only publications that were available in English and published between January 2000 and September 2021 due to time and resource constraints. Four of the included studies were conducted in the United States and one in Indonesia. The sample size ranged from 24 to 465 members of the general public or bystanders. Community members gained increased knowledge and abilities regarding disaster preparedness strategies and procedures. The first aid training content focused on prehospital trauma care, including training on the ABCs, dealing with disasters in the community, calling for help, identifying the location of life-threatening bleeding and applying pressure, and packing a wound and applying a tourniquet for bleeding control. A training program emphasizing both first aid methods and inhibitors of behaviors to help in an emergency was found to be significantly associated with increased rates of assistance during emergency situations. Keywords: community first aid, training, disaster preparedness, review

Smartphone activated community first responders’ experiences of out-of-hospital cardiac arrests alerts, a qualitative study

Abstract: The aim was to illustrate how community first responders perceive out-of-hospital cardiac arrest alerts delivered via smartphone, what support they have and how they cope with potentially distressing experiences.A qualitative interview study was conducted with a volunteer sample of 14 community first responders in two regions of Sweden. The interviews were transcribed and analysed using thematic analysis with a data-driven inductive approach supported by NVivo 1.3.The responders' experiences were illustrated in three main themes, each including several subthemes: 1) Profound wish to help, including the sense of importance and sense of emergency; 2) Facing the situation, including essential actions performed in collaboration, confidence from training and experience, challenges posed by unforeseen situations and ethical dilemmas, and coping with emotional reactions; and 3) Potential for improvements, including technical and communication development, feedback and debriefing, training and social marketing.The community first responders were motivated and eager to help but simultaneously feared the mission and were not always prepared for their own reactions in the emergency when dispatched. Although cardiopulmonary resuscitation training and experience gave them skills that enabled them to act constructively, they faced situations that might be facilitated by improvements in the community first responder system and further training. The responders were proud of their efforts and were good ambassadors for the system. Appreciation of their commitment, better preparation and providing support in the aftermath of an emergency appears to be a good investment in societies' efforts to bring quick help to distressed persons.

Obstacles to mental health treatment: Similarities and differences among first responder groups

Abstract: First responders have been shown to be at risk for several negative mental health outcomes. However, it is not always clear how to intervene to prevent these outcomes. One approach has been to try to reduce the obstacles to care that might be imposed by the profession or the organization. In this paper, we investigate whether the nature of these obstacles varies as a function of the type of job. A group of 1,485 first responders were studied. The results indicate a number of important specialty-related differences. The results are discussed in terms of how to tailor prevention programs to confront obstacles to care.

Increased bystander intervention when volunteer responders attend out-of-hospital cardiac arrest

Abstract: Aim The primary aim was to investigate the association between alarm acceptance compared to no-acceptance by volunteer responders, bystander intervention, and survival in out-of-hospital cardiac arrest. Materials and methods This retrospective observational study included all suspected out-of-hospital cardiac arrests (OHCAs) with activation of volunteer responders in the Capital Region of Denmark (1 November 2018 to 14 May 2019), the Central Denmark Region (1 November 2018 to 31 December 2020), and the Northern Denmark Region (14 February 2020 to 31 December 2020). All OHCAs unwitnessed by Emergency Medical Services (EMS) were analyzed on the basis on alarm acceptance and arrival before EMS. The primary outcomes were bystander cardio-pulmonary resuscitation (CPR), bystander defibrillation and secondary outcome was 30-day survival. A questionnaire sent to all volunteer responders was used with respect to their arrival status. Results We identified 1,877 OHCAs with volunteer responder activation eligible for inclusion and 1,725 (91.9%) of these had at least one volunteer responder accepting the alarm (accepted). Of these, 1,355 (79%) reported arrival status whereof 883 (65%) arrived before EMS. When volunteer responders accepted the alarm and arrived before EMS, we found increased proportions and adjusted odds ratio for bystander CPR {94 vs. 83%, 4.31 [95% CI (2.43–7.67)] and bystander defibrillation [13 vs. 9%, 3.16 (1.60–6.25)]} compared to cases where no volunteer responders accepted the alarm. Conclusion We observed a fourfold increased odds ratio for bystander CPR and a threefold increased odds ratio for bystander defibrillation when volunteer responders accepted the alarm and arrived before EMS.

Enabling Remote Responder Bio-Signal Monitoring in a Cooperative Human–Robot Architecture for Search and Rescue

Abstract: The roles of emergency responders are challenging and often physically demanding, so it is essential that their duties are performed safely and effectively. In this article, we address real-time bio-signal sensor monitoring for responders in disaster scenarios. In particular, we propose the integration of a set of health monitoring sensors suitable for detecting stress, anxiety and physical fatigue in an Internet of Cooperative Agents architecture for search and rescue (SAR) missions (SAR-IoCA), which allows remote control and communication between human and robotic agents and the mission control center. With this purpose, we performed proof-of-concept experiments with a bio-signal sensor suite worn by firefighters in two high-fidelity SAR exercises. Moreover, we conducted a survey, distributed to end-users through the Fire Brigade consortium of the Provincial Council of Málaga, in order to analyze the firefighters’ opinion about biological signals monitoring while on duty. As a result of this methodology, we propose a wearable sensor suite design with the aim of providing some easy-to-wear integrated-sensor garments, which are suitable for emergency worker activity. The article offers discussion of user acceptance, performance results and learned lessons.

Job-Related Performance and Quality of Life Benefits in First Responders Given Access to H-Wave® Device Stimulation: A Retrospective Cohort Study

Abstract: Current chronic pain treatments primarily target symptoms and are often associated with harmful side-effects and complications, while safer non-invasive electrotherapies like H-Wave® device stimulation (HWDS) have been less explored. The goal of this study is to evaluate first responder-reported effects of HWDS on job-related and quality-of-life measures. This is a retrospective cohort study where first responders were surveyed following voluntary use of HWDS regarding participant experience, frequency of use, job-related performance, and quality-of-life. Responses were analyzed using means comparison tests, while bivariate analysis assessed responses associated with HWDS usage. Overall, 92.9% of first responder HWDS users (26/28) reported a positive experience (p < 0.0001), with 82.1% citing pain reduction (p = 0.0013), while 78.6% indicated it would be beneficial to have future device access (p = 0.0046). Participants using H-Wave® were at least six times more likely to report higher rates of benefit (100% vs. 0%, p = 0.022), including pain reduction (91.3% vs. 8.7%, p = 0.021) and improved range-of-motion (93.3% vs. 69.2%, p = 0.044). Spending more time with family was associated with better job performance following frequent HWDS use (50% vs. 8.3%, p = 0.032). Repetitive first responder H-Wave® use, with minimal side effects and easy utilization, resulted in significant pain reduction, improvements in job performance and range-of-motion, and increased time spent with family, resulting in overall positive experiences and health benefits. Level of Evidence: III.

Smartphone-activated volunteer responders and bystander defibrillation for out-of-hospital cardiac arrest in private homes and public locations

Abstract: Abstract Aims To investigate the association between the arrival of smartphone-activated volunteer responders before the Emergency Medical Services (EMS) and bystander defibrillation in out-of-hospital cardiac arrest (OHCA) at home and public locations. Methods and results This is a retrospective study (1 September 2017–14 May 2019) from the Stockholm Region of Sweden and the Capital Region of Denmark. We included 1271 OHCAs, of which 1029 (81.0%) occurred in private homes and 242 (19.0%) in public locations. The main outcome was bystander defibrillation. At least one volunteer responder arrived before EMS in 381 (37.0%) of OHCAs at home and 84 (34.7%) in public. More patients received bystander defibrillation when a volunteer responder arrived before EMS at home (15.5 vs. 2.2%, P < 0.001) and in public locations (32.1 vs. 19.6%, P = 0.030). Similar results were found among the 361 patients with an initial shockable heart rhythm (52.7 vs. 11.5%, P < 0.001 at home and 60.0 vs. 37.8%, P = 0.025 in public). The standardized probability of receiving bystander defibrillation increased with longer EMS response times in private homes. The 30-day survival was not significantly higher when volunteer responders arrived before EMS (9.2 vs. 7.7% in private homes, P = 0.41; and 40.5 vs. 35.4% in public locations, P = 0.44). Conclusion Bystander defibrillation was significantly more common in private homes and public locations when a volunteer responder arrived before the EMS. The standardized probability of bystander defibrillation increased with longer EMS response times in private homes. Our findings support the activation of volunteer responders and suggest that volunteer responders could increase bystander defibrillation, particularly in private homes.

Interprofessional collaboration among first responder students in a simulated disaster exercise.

Abstract: INTRODUCTION Interprofessional disaster simulation exercises provide an opportunity for first responder students to learn about disaster response and recovery, to practice their roles and to learn to collaborate with other first responders. With the move to virtual education during the COVID-19 pandemic, a table-top disaster exercise is an alternative format to inperson exercises. To date, most disaster simulation exercises for students have focused on the roles of healthcare providers. As first responders play a critical role in disaster management, there is a need for interprofessional exercises that include students in first responder programs. METHODS A table-top disaster simulation exercise was held with students from the police (n = 94) and firefighter (n = 30) programs at a large community college in Toronto, Canada, in February 2021. It was held virtually using the Zoom® platform, with college faculty as well as professionals from community partner sites. An evaluation survey that had open- and closed-ended items was administered to students following the event. RESULTS Thirty-eight percent of the students participated in the survey, and the majority rated the event highly useful and reported that the exercise demonstrated the importance of interprofessional collaboration. Students' responses to the open-ended survey items yielded two themes: understanding roles and performing under duress. DISCUSSION This evaluation demonstrates the value of using a simulated disaster exercise to teach first responder students about their role in disaster response and recovery, and the importance of interprofessional collaboration.

Emergency Preparedness for Sudden Cardiac Arrest in Amateur Athletic Union Basketball Teams: An Opportunity to Improve Outcomes in Higher Risk Athletes

Abstract: To examine sudden cardiac arrest (SCA) awareness and emergency preparedness for SCA in Amateur Athletic Union (AAU) youth basketball teams.Cross-sectional survey of AAU coaches and administrators.Random sampling of AAU club teams across the United States.AAU club coaches and/or administrators.Electronic survey (Qualtrics) accessed online and by cell phone. Each coach/administrator was invited to participate via email up to 3 times, spaced approximately 5 days apart.Established and practiced emergency action plan (EAP), cardiopulmonary resuscitation (CPR) training, and automated external defibrillator (AED) access.A total of 53/449 (12%) respondents completed the survey. Only 6% of responding AAU clubs had a written EAP and practiced it on an annual basis. Only 35% of clubs required CPR training for their coaches. Automated external defibrillator were available at practices and games in only 45% and 35% of AAU clubs, respectively. Over 50% of clubs did not have an affiliated athletic trainer or medical director.The vast majority of AAU clubs in this study lack proper emergency preparedness for SCA. Given male basketball players are at highest risk of SCA compared with other young athlete populations, urgent interventions are needed to improve awareness, standardize training, establish EAPs, and ensure access to AEDs in AAU clubs.

Uncomfortable yet necessary: The impact of PPE on communication in emergency medicine.

Abstract: BACKGROUND The efficacy of pre-hospital emergency services is heavily dependent on the effective communication of care providers. This effective communication occurs between providers as part of a team, but also among providers interacting with family members and patients. The COVID-19 pandemic introduced a number of communication challenges to emergency care, which are primarily linked to the increased use of PPE. METHODS We sought to analyze the impacts of the Covid-19 pandemic on Emergency Medical Service (EMS) workers and pre-hospital care delivery. We conducted focus groups and one-on-one interviews with fire-EMS first responders between Sept 2021 and 2022. Interviews included questions about job related stress, EMS skills, work experiences and changes during Covid-19. Interviews were recorded, independently dual coded, and analyzed for themes. RESULTS 223 first responders participated in 40 focus groups and 40 lead paramedics participated in individual interviews. We found that additional use of personal protective-equipment (PPE) was reported to have significantly impaired efficiency and perceptions of quality of care-among EMS team members and also between EMS workers and patients. EMS personnel also experienced on scene hostility on arrival (from both families and other agencies). Use of extensive PPE muffles voices, obscures facial expressions, and can cause team members to have difficulty recognizing and communicating with one another and can be a barrier to showing empathy and connecting with patients. Creative solutions such as putting a hand on someone's shoulder, wearing name tags on suits, and explaining rationale for perceived delays were mentioned as methods to transcend these barriers. The appearance of providers in heavy PPE can be unsettling and create barriers to human connection, particularly for pediatric patients. CONCLUSION Human connection is an important element of health care delivery and healing. These findings shed light on new skills that are needed to initiate and maintain human connection in these times of PPE use, especially full body PPE. Awareness of the communication and empathy barriers posed by PPE is the first step to improving provider-patient interactions in pre-hospital EMS. Additionally, 'communication-friendly' adaptations of PPE equipment may be an important area for future research and development in manufacturing and the healthcare industry.

Naloxone Plus, Plus Some: Examining Ohio's Quick Response Teams Through the Lens of Deflection

Abstract: There were nearly 50 000 opioid-related deaths in 2019 in the United States.* The dramatic frequency of opioid overdoses and fatalities has led to strained community resources, especially among hospitals and first responders (law enforcement, fire, and emergency medical services). In response to rising overdose rates, many first responders have implemented programs that align public health and public safety responses to overdoses. Often called “Quick Response Teams” (QRTs), these programs leverage a collaborative team to respond to those at risk of overdose, or who have survived an overdose. The initial QRT was implemented in Colerain Township, Ohio, in 2015.† Today, QRTs are a widely accepted “model” overdose response program.‡ Despite the popularity of QRTs, research on the model is limited. In this article, the authors use existing qualitative and quantitative data from QRTs across the state of Ohio to examine QRTs. Using the lens of the Police, Treatment and Community Collaborative's 5 deflection pathways, the authors answer four key questions: (1) What is the scale of QRTs in Ohio, and how are QRTs in our sample structured? (2) Whom are the QRTs serving? (3) How many pathways of deflection are reflected in Ohio's QRTs? (4) What can these data teach us about the context of the QRT work and (more generally) collaborative overdose response? After examining the QRTs and their data, the authors provide suggestions to help researchers, practitioners, and funders better understand QRTs and similar public health/public safety partnerships.

Resilient Communication for Dynamic First Responder Teams in Disaster Management

Abstract: Effective communication among first responders during and in the aftermath of a disaster can dramatically affect outcomes - saving lives by providing appropriate, timely assistance. In this article, we discuss the design of a resilient architecture that enables effective first responder communications in the challenging situations caused by a disaster. Our ReDiCom (Resilient Disaster Communications) architecture builds resilience into its framework across all the layers. The information layer allows communication by roles and identities instead of addresses to support communication among dynamically formed first responder teams. The network layer provides robust and resilient communication even when facilities are error- and disruption-prone. Our coded computation further improves resilience and enables efficient distributed data processing potentially with first responder and civilian mobile devices.

Unit Collective Medical Training in the 75th Ranger Regiment.

Abstract: The 75th Ranger Regiment's success with eliminating preventable death on the battlefield is innate to the execution of a continuous operational readiness training cycle that integrates individual and unit collective medical training. This is a tactical solution to a tactical problem that is solved by the entire unit, not just by medics. When a casualty occurs, the unit must immediately respond as a team to extract, treat, and evacuate the casualty while simultaneously completing the tactical mission. All in the unit must maintain first responder medical skills and medics must be highly proficient. Leaders must be prepared to integrate casualty management into any phase of the mission. Leaders must understand that (1) the first casualty can be anyone; (2) the first responder to a casualty can be anyone; (3) medical personnel manage casualty care; and (4) leaders have ownership and responsibility for all aspects of the mission. Foundational to training is a command-directed casualty response system which serves as a forcing function to ensure proficiency and mastery of the basics. Four programs have been developed to train individual and collective tasks that sustain the Ranger casualty response system: (1) Ranger First Responder, (2) Advanced Ranger First Responder, (3) Ranger Medic Assessment and Validation, and (4) Casualty Response Training for Ranger Leaders. Unit collective medical training incorporates tactical leader actions to facilitate the principles of casualty care. Tactical leader actions are paramount to execute a casualty response battle drill efficiently and effectively. Successful execution of this battle drill relies on a command-directed casualty response system and mastery of the basics through rehearsals, repetition, and conditioning.

Interprofessional collaboration among first responder students in a simulated disaster exercise

Abstract: Introduction: Interprofessional disaster simulation exercises provide an opportunity for first responder students to learn about disaster response and recovery, to practice their roles and to learn to collaborate with other first responders. With the move to virtual education during the COVID-19 pandemic, a table-top disaster exercise is an alternative format to in-person exercises. To date, most disaster simulation exercises for students have focused on the roles of healthcare providers. As first responders play a critical role in disaster management, there is a need for interprofessional exercises that include students in first responder programs.Methods: A table-top disaster simulation exercise was held with students from the police (n = 94) and firefighter (n = 30) programs at a large community college in Toronto, Canada, in February 2021. It was held virtually using the Zoom® platform, with college faculty as well as professionals from community partner sites. An evaluation survey that had open- and closed-ended items was administered to students following the event.Results: Thirty-eight percent of the students participated in the survey, and the majority rated the event highly useful and reported that the exercise demonstrated the importance of interprofessional collaboration. Students’ responses to the open-ended survey items yielded two themes: understanding roles and performing under duress.Discussion: This evaluation demonstrates the value of using a simulated disaster exercise to teach first responder students about their role in disaster response and recovery, and the importance of interprofessional collaboration.

Characteristics and motivational factors for joining a lay responder system dispatch to out-of-hospital cardiac arrests

Abstract: 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.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.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).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.

Conclusions and Recommendations, Policy Implications, and Future Research

Abstract: Suicide deaths among our first responder populations have gained growing national attention. Yet, many remain misinformed about the true extent of suicide within law enforcement ranks, with some believing this is a new phenomenon. However, those working and researching in the field know suicide has been a leading cause of mortality for decades. Unfortunately, because stigma and shame often accompany these types of death, many who die by their own hand often remain unknown, and all too often forgotten. Seemingly, only sensationalistic cases or cases of murder-suicide seem to receive any kind of attention. This surreptitious threat to our public safety professionals has yet to receive the same level of concern or attention as other threats, though this is slowly changing.

Abstract 295: Availability Of Automatic Defibrillators And Volunteer Responders For Out-of-hospital Cardiac Arrest In Denmark

Abstract: Introduction: Public automatic defibrillators (AEDs) and bystander resuscitation (CPR) are critical for cardiac arrest survival. We examined how availability of AEDs and volunteer responders that can be summoned with an app have developed following many national initiatives to improve survival. Methods: All OHCA (Out-of-Hospital Cardiac Arrest) registered with coordinates within the Danish Cardiac Arrest Registry (2016-2020) were included. This study assessed coverage of 1) AEDs and 2) volunteer responders at 12 noon for home and public OHCAs. Coverage was defined as ≥ 1 AED and ≥ 4 volunteer responders within 200, 500, or 1,800 meters using straight line distance from the OHCA. Results: A total of 22,330 OHCAs were included. At 12 noon, 33,180 volunteer responders (572/100,000 inhabitants) and 22,418 AEDs (387/100,000 inhabitants) were available. More OHCA were covered with AEDs compared to volunteer responders for all distances. A significant difference was found in AED coverage in public compared to home arrests for all distances (p for difference at all distances <0.05). Opposite, no difference was found in volunteer responder coverage for home compared to public arrests at 1,800 and 500 meters (p for difference >0.05). Figure 1 illustrates AED and volunteer responder coverage for home and public arrest. Conclusion: Following the implementation of a national volunteer responder program and strategic placement of AEDs in Denmark, most historical OHCAs were covered by AEDs and volunteer responders within 1,800 meters. Although we have more volunteer responders per 100,000 inhabitants compared to AEDs, we found more than half (53%) of all OHCA were covered with AEDs within 200 meters whereas only 16% of all OHCAs were covered by volunteer responders within 200 meters. These findings indicate strategic AED placement in Denmark, but further efforts regarding volunteer responder recruitment are needed to increase coverage of the historical OHCA in Denmark.

First Responders and Mental Health

Abstract: First responders include police officers, firefighters, and emergency medical technicians. Given occupational demands, first responders are chronically exposed to stress and potentially traumatic events in the line-of-duty. An emergent literature has documented the mental health sequelae of first responding. The goal of this article is to provide an overview of mental health among first responders, including a review of prevalent mental health conditions, discussion of risk and protective factors related to mental health and well-being, and discussion of the efficacy of evidence-based mental health treatments. This article will also discuss clinical applications and research recommendations regarding first responder mental health.

Impact of Online AHA Heartsaver First Aid CPR AED Course Amongst Non-medical Post Graduate Students

Abstract: Aim: To understand the impact of online AHA Heartsaver First Aid CPR AED course training amongst non-medical students in Pune, India Introduction: Global statistics reveal, the mortality rate due to road traffic accidents is as high as 1.2 million per year. Numerous studies have shown that the society at large is in urgent need of more skilled in the form of first aid responder. This goal can be fulfilled and achieved by enhancing the number of first responders within our society. With the advent of Covid-19 pandemic, opportunities for face-to-face training have significantly deprived critical knowledge sharing to the general population. The pandemic is long drawn and has forced us to devise novel methods of knowledge delivery to ensure that crucial aspects of First Aid and Emergency Care are taught to the general population. The present study aims to understand the impact of online AHA Heartsaver First Aid CPR AED course training amongst non-medical students in Pune, India. Objective: To study the impact of online AHA – Heartsaver First Aid CPR AED course among non-medical students in Pune, India. Methodology: The knowledge retention study was conducted amongst 250 Post Graduate Management students based in Pune. In order to assess the true impact of the AHA - Heartsaver First Aid CPR AED online training, only those students who had not undergone any previous, formal training in First Aid and CPR concepts were chosen for the study. The baseline knowledge of the respondents was assessed with a pre-designed 30 item and pre-validated 30 item Multiple Choice Questionnaire provided by the American Heart Association. Conclusion: E-learning is the way forward and it allows training of a large group of individuals in a singular event. This can help propagate first aid training to the masses. The study findings are encouraging in terms of improvement in the knowledge scores immediately after a single online training session. Although the knowledge tends to diminish after a period of eight weeks.

Developing a geographic strategy for equal rapid response first aid

Abstract: Abstract Background: All people have rights to take first aids equally because they have risk for sudden cardiac arrest at any time. Japan employs mainly two inclusive strategies for rapid response first aid. The first is public services such as fire trucks and ambulance response. The second is increasing the number of first responders. However, many residents are geographically unaware whether public services in their areas provide quick responses during emergencies, such as cardiac arrest. For this reason, they lack knowledge the necessity of mutual aid, which enables nearby neighbors who have undergone proper training to respond and provide first aid. Thus, the study aims to identify geographically specific areas where mutual aid is essential for rapid response first aid. Methods: The study targeted 20 cities in Japan designated by government ordinance and to simulate response areas reachable by public service. The driving conditions with 3 min were simulated with the speed limits, which are obeyed by the Japanese Road Traffic Act. Also, the populations covered in the areas was calculated in each targeted city. Results: The simulated map appears to render easy recognition of weak areas that may benefit from rapid response and may necessitate mutual aid. The maximum, minimum, and median population coverage rates are 65%, 22%, and 38.5%, respectively. Conclusion: The study indicates that mutual aid for rapid response is essential to most of the targeted areas in the case of sudden cardiac arrest. Moreover, mutual aid can be implemented strategically by geographic visualization and numerical values for equal rapid response first aid.