Enhancing citizens response to out-of-hospital cardiac arrest: A systematic review of mobile-phone systems to alert citizens as first responders

Tommaso Scquizzato, Ottavia Pallanch, Alessandro Belletti, Antonio Frontera, Luca Cabrini, Alberto Zangrillo, Giovanni Landoni

Research output: Contribution to journalReview articlepeer-review

Abstract

Introduction: Involving laypersons in response to out-of-hospital cardiac arrest through mobile-phone technology is becoming widespread in numerous countries, and different solutions were developed. We performed a systematic review on the impact of alerting citizens as first responders and to provide an overview of different strategies and technologies used. Methods: We searched electronic databases up to October 2019. Eligible studies described systems to alert citizens first responders to out-of-hospital cardiac arrest through text messages or apps. We analyzed the implementation and performance of these systems and their impact on patients’ outcomes. Results: We included 28 manuscripts describing 12 different systems. The first text message system was implemented in 2006 and the first app in 2010. First responders accepted to intervene in median (interquartile) 28.7% (27–29%) of alerts and reached the scene after 4.6 (4.4–5.5) minutes for performing CPR. First responders arrived before ambulance, started CPR and attached a defibrillator in 47% (34–58%), 24% (23–27%) and 9% (6–14%) of cases, respectively. Pooled analysis showed that first responders activation increased layperson-CPR rates (1463/2292 [63.8%] in the intervention group vs. 1094/1989 [55.0%] in the control group; OR = 1.70; 95% CI, 1.11–2.60; p = 0.01) and survival to hospital discharge or at 30 days (327/2273 [14.4%] vs. 184/1955 [9.4%]; OR = 1.51; 95% CI, 1.24–1.84; p < 0.001). Conclusions: Alerting citizens as first responders in case of out-of-hospital cardiac arrest may reduce the intervention-free time and improve patients’ outcomes.

Original languageEnglish
Pages (from-to)16-25
Number of pages10
JournalResuscitation
Volume152
DOIs
Publication statusPublished - Jul 2020

Keywords

  • Cardiopulmonary resuscitation
  • First responders
  • Mobile-phone technology
  • Out-of-hospital cardiac arrest

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

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