First responder systems can stay operational under pandemic conditions: results of a European survey during the COVID-19 pandemic

Camilla Metelmann; Bibiana Metelmann; Michael P Müller; Bernd W Böttiger; Georg Trummer; Karl Christian Thies

doi:10.1186/s13049-022-00998-3

First responder systems can stay operational under pandemic conditions: results of a European survey during the COVID-19 pandemic

Scand J Trauma Resusc Emerg Med. 2022 Feb 19;30(1):10. doi: 10.1186/s13049-022-00998-3.

Authors

Camilla Metelmann¹, Bibiana Metelmann², Michael P Müller³, Bernd W Böttiger⁴, Georg Trummer⁵, Karl Christian Thies⁶

Affiliations

¹ Department of Anaesthesiology, University Medicine Greifswald, Ferdinand-Sauerbruch Straße 1, 17475, Greifswald, Germany. camilla.metelmann@uni-greifswald.de.
² Department of Anaesthesiology, University Medicine Greifswald, Ferdinand-Sauerbruch Straße 1, 17475, Greifswald, Germany.
³ Department of Anaesthesiology, Intensive Care and Emergency Medicine, St. Josefskrankenhaus, Sautierstraße 1, 79104, Freiburg im Breisgau, Germany.
⁴ Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Köln, Germany.
⁵ Department of Cardiac and Vascular Surgery, University Cardiac Centre Freiburg - Bad Krozingen, Hugstetter Straße 55, 79106, Freiburg, Germany.
⁶ Klinik für Anästhesiologie, EvKB, Universitätsklinikum OWL der Universität Bielefeld, Campus Bielefeld-Bethel, Burgsteig 13, 33617, Bielefeld, Germany.

Abstract

Background: Dispatching first responders (FR) to out-of-hospital cardiac arrest in addition to the emergency medical service has shown to increase survival. The promising development of FR systems over the past years has been challenged by the outbreak of COVID-19. Whilst increased numbers and worse outcomes of cardiac arrests during the pandemic suggest a need for expansion of FR schemes, appropriate risk management is required to protect first responders and patients from contracting COVID-19. This study investigated how European FR schemes were affected by the pandemic and what measures were taken to protect patients and responders from COVID-19.

Methods: To identify FR schemes in Europe we conducted a literature search and a web search. The schemes were contacted and invited to answer an online questionnaire during the second wave of the pandemic (December 2020/ January 2021) in Europe.

Results: We have identified 135 FR schemes in 28 countries and included responses from 47 FR schemes in 16 countries. 25 schemes reported deactivation due to COVID-19 at some point, whilst 22 schemes continued to operate throughout the pandemic. 39 schemes communicated a pandemic-specific algorithm to their first responders. Before the COVID-19 outbreak 20 FR systems did not provide any personal protective equipment (PPE). After the outbreak 19 schemes still did not provide any PPE. The majority of schemes experienced falling numbers of accepted call outs and decreasing registrations of new volunteers. Six schemes reported of FR having contracted COVID-19 on a mission.

Conclusions: European FR schemes were considerably affected by the pandemic and exhibited a range of responses to protect patients and responders. Overall, FR schemes saw a decrease in activity, which was in stark contrast to the high demand caused by the increased incidence and mortality of OHCA during the pandemic. Given the important role FR play in the chain of survival, a balanced approach upholding the safety of patients and responders should be sought to keep FR schemes operational.

Keywords: Cardiac arrest; Citizen first responder; Community first responder; Covid-19; First responder; OHCA; Pandemic; Personal protective equipment; Resuscitation; Survey.

MeSH terms

COVID-19*
Cardiopulmonary Resuscitation* / methods
Emergency Responders*
Humans
Out-of-Hospital Cardiac Arrest*
Pandemics
SARS-CoV-2
Surveys and Questionnaires