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Table 2 Characteristics of dispatched citizen-responders

From: First-response treatment after out-of-hospital cardiac arrest: a survey of current practices across 29 countries in Europe

Country, Region

Active system

Method to activate

Location determination

1. Response needed

Role onscene

Equipment

Training; Frequency

Registration

Feedback

Financial assistance

Emotional support

Other requirements to become a citizen-responder

2. Information provided by dispatcher

Austria

(N = 8.220.000)

24 h/7

Standard communication system; SMS; Pager; APP

GPS

1. Confirming the response

2. Location of victim; location of AED

1. AED (private use);

2. Attach pads and follow AED instructions;

3. Perform CPR

1. AED;

2. Safety jacket;

3. Rescuer Kit

Yes trained for CPR including use of an AED; Annually

In an online system: Online App (for EMS, Paramedics, Medical Students, Physicians) or as designated First Responders (EMS/Paramedics) that are on call (during their free time)

Citizen-responders receive a regular report of their activity/Designated EMS staff discuss calls attended with citizen-responders

Yes: equipment and AED related disposables

Yes

A minimum of 18 years for the citizen-responders is required

Czech Republic Hradec Kralove Region

(N = 550.804)

24 h/7

SMS; APP

GPS

1. Confirming the response

2. Location of victim; location of AED; situational information (Possibility to call dispatch centre for additional information)

1. Get a local AED; connect a breathing mask;

2. Attach pads and follow AED instructions;

3. Perform CPR

Of note: Citizen-responders usually do not bring AEDs to the victim (density of local AEDs is low). They usually replace bystanders or relatives in doing high-quality CPR

1. Safety jacket;

2. Pocket mask,

3. Smartphone

Yes trained for CPR including use of an AED; Any valid ERC course certificate is needed

In an online system: SW KISS SHARP (new name: O2 SOS), registration and information at fr.zzskhk.cz

Letter of thanks

Yes: safety vest, pocket mask, until 2017 also smartphone

Yes, critical incident stress management available on request

A minimum of 18 years for the citizen-responders is required and they must declare to have no criminal history. This must be proven by an official document issued by the state-wide registry.

Denmark, Capital region, Central Region

(N = 3.137.000)

24 h/7

APP

GPS

1. Confirming the response

2. Location of victim; location of nearest accessible AED

1. Get a local AED;

2. Attach pads and follow AED instructions;

3. Perform CPR

1. AED

Not required but strongly recommended

In an online system: In the app server

Via mail and social media when asked for

No

Yes, critical incident stress management available on request

A minimum of 18 years for the citizen-responders is required

Denmark, Region Zealand, Region South

(N = 2.056.025)

24 h/7

APP

GPS

1. Confirming the response

2. Location of victim; location of AED

1. Get a local AED;

2. Attach pads and follow AED instructions;

3. Perform CPR;

4. If the citizen responder wants: guide the ambulance to the right address and assist the ambulance personnel.

1. AED

Yes trained for CPR including use of an AED; at least a 4 h CPR training course

In an online system: In the app server

Via mail and social media when asked for

No

Yes, critical incident stress management available on request

A minimum of 18 years for the citizen-responders is required and absence of a criminal history regarding child abuse

Englanda

(N = 55.980000)

24 h/7

APP

GPS and Address

1. Confirming the response

2. Location of victim; demographics (victim) and situational information

1. Get an AED out of the vehicle;

2. Connect a breathing mask;

3. Attach pads and follow AED instructions;

4. Perform CPR;

5. They are trained in airway management

1. AED;

2. Rescuer Kit

Yes trained for CPR including use of an AED; Annually

In an online system: In house database

Citizen-response activity is described in the annual report/Citizen-responders receive a regular report of their activity/Citizen-responders receive written feedback on individual calls from the EMS

No

Yes

Each Trust sets its own parameters. Most require a minimum of 16 or 18 years for the citizen-responders. Also, the criminal record is checked.

Germanyb, Marburg-Biedenkopf, Gütersloh, Freiburg, Neckar-Odenwald-Kreis, Greifswald, Schleswig-Holstein

(N = 3.661.774)

24/7

SMS; APP

GPS

1. Confirming the response

2. Location of victim; location of AED

1. Get a local AED;

2. Connect a breathing mask;

3. Attach pads and follow AED instructions;

4. Perform CPR

1. AED;

2. Safety jacket;

3. Rescuer Kit

Yes trained for CPR including use of an AED; Annually

In an online system: In the app server/German Red Cross

No

No

Yes, they can choose to contact a special team for debriefing

A minimum age of 18 years for the responders is required

Ireland

(N = 4.830.000)

24 h/7

SMS

Not determined

1. Confirming the response

2. Location of victim; location of AED; demographics (victim) and situational information

1. Get a local AED or get an AED out of the vehicle;

2. Connect a breathing mask;

3. Attach pads and follow AED instructions;

4. Perform CPR

1. AED;

2. Safety jacket;

3. Resuscitation kit bag

Yes trained for CPR including use of an AED; Monthly

Authorisation granted by Ambulance Officer

Citizen-response activity is described in the annual report/Citizen-responders receive a regular report of their activity/Designated EMS staff discuss calls attended with citizen-responders

Replacement of consumable equipment

Yes

A minimum age of 18 years for the citizen-responders is required and they must get Garda Clearance, i.e., confirmation must be received from the Irish police that the person does not have a criminal conviction of significance

Italy

Emilia Romagna

(N = 4.453.000)

24 h/7

APP

GPS

1. Confirming the response

2. Location of victim; location of AED

1. Get a local AED; connect a breathing mask;

2. Attach pads and follow AED instructions;

3. Perform CPR

None

Yes trained for CPR including use of an AED; Bi-annually

In an online system: https://www.118er.it/dae/

The responder manager sends an email to collect feedback by mail (but is not a routine)

No

No

No requirements

Hungary

(N = 9.800.000)

24 h/7

Standard communication system; APP

GPS

1. One person from the dispatch centre calls the citizen to check whether she/he is able to go to the victim

2. Location of victim; location of AED

1. Get a local AED; 2. Attach pads and follow AED instructions;

3. Perform CPR

1. AED

Not required; There is not any training for them, it depends on the citizen.

In an online system: Szív city (szivcity.hu)

None

No

No

No requirements

The Netherlands Except Amsterdam

(N = 15.835350)

24 h/7

SMS; APP

GPS; Address

1. No response is required

2. Location of victim; location of AED

1. Get a local AED or get an AED out of the vehicle;

2. Attach pads and follow AED instructions;

3. Perform CPR

1. AED

Yes trained for CPR including use of an AED; Annually

In an online system: Hartslag.nu

None

No

Hartslag.nu asks for an evaluation after the event

A minimum age of 18 years is required and no dispatch to OHCAs caused by a trauma or in children < 8 years

Romania, Bucharest

(N = 1.828.000)

NR

SMS

GPS

1. No response is required

2. Location of victim; location of AED

1. Get a local AED;

2. Attach pads and follow AED instructions;

3. Perform CPR

1. AED

Yes trained for CPR including use of an AED; Only trained once

NR

Activity is described in the annual report

No

Informal emotional support from Ambulance Service Staff

A minimum age of 16 years for the citizen-responders is required

Sweden, Norrbotten County

(N = 251.295)

24 h/7

SMS

Triangulation by telephone towers

1. No response is required

2. Location of victim

1. Perform CPR

None

Yes trained for CPR including use of an AED; Responders should be educated but no specific follow up is done

In an online system: https://www.mobilraddare.se/

NR

Yes, please describe the type of assistance given: not specified

Yes, if requested they can contact the project via email/telephone

A minimum age of 18 years is required and no dispatch to children < 8 years

Sweden, Region western Sweden

(N = 2.016.000)

During daytime: 07:00–22:59

SMS

GPS

1. Confirming the response

2. Location of victim; location of AED

1. Get a local AED or get an AED out of the vehicle;

2. Attach pads and follow AED instructions;

3. Perform CPR

None

Yes trained for CPR including use of an AED; All should be trained once. The repetitions courses differs between individuals

Directly in the APP

None

No

Yes, crisis consultation if requested.

A minimum age of 18 years for the citizen-responders is required and no dispatch to children < 8 years

Sweden, Stockholm

(N = 965.232)

During daytime: 07:00–22:59

SMS; APP

GPS

1. Confirming the response

2. Location of victim; location of AED and situational information

1. Get a local AED;

2. Attach pads and follow AED instructions;

3. Perform CPR

None

Yes trained for CPR including use of an AED; Only trained once

In an online system: Register directly via application

Via mail and social media when asked for

No

Yes, debriefing if needed (if requested crisis counselling is given up to 10 visits)

A minimum age of 18 years is required and no dispatch to children < 8 years

Scotland

(N = 543.800)

Book on with the control centre when available. Therefore, their coverage varies across the country at any given time

Standard communication system

GPS

1. Confirming the response

2. Location of victim; situational information

1. Get an AED out of the vehicle;

2. Connect a breathing mask;

3. Attach pads and follow AED instructions;

4. Perform CPR;

5. Insert airway if required

1. AED;

2. Safety jacket;

3. Rescuer Kit

Yes trained for CPR including use of an AED; Community First Responders go through an initial 4 day training course and then are expected to attend monthly training sessions within their groups, which follow a structured programme

In an online system: After training and suitability checks have been completed they are put on a database and classed as an active responder) and then when available they book on and ACC colleagues can deploy them

Citizen-response activity is described in the annual report; Designated EMS staff discuss calls attended with citizen-responders/Citizen-responders receive written feedback on individual calls from the EMS/We have a network of Community Resilience Facilitators who meet with Community First Responder groups periodically and are available to support them

Yes: the can claim mileage costs if they have used their own vehicle. Scottish Ambulance Service also replaces any consumable items used during the course of the first responders attendance

Yes

A minimum age of 18 years for the citizen-responders is required and dispatch to adults only; all citizen-responders undergo a protection of vulnerable groups (PVG) check and, depending on feedback, a judgement is made on the suitability to be a citizen-responder.

Switzerland, Ticino Canton

(N = 353.709)

24 h/7

APP

Not determined

1. Confirming the response

2. Location of victim; location of AED; demographic and situational information

1. Get a local AED; 2. Connect a breathing mask

1. Safety jacket

Yes trained for CPR including use of an AED; Bi-annually

In an online system: smartphone Application (MOMENTUM) and registration program created by us (fr.ticinocuore.ch)

Receive written feedback on individual calls from the EMS/ Participate in a debrief with EMS staff immediately after an OHCA/ Receive feedback based on AED data from the operational and clinical manager/Are invited to the annual ceremony, where survivors meet first responders

No

Yes, 24 h/7 days team of psychological counsellors

A minimum age of 18 years is required (of note: citizens are allowed to use an AED from age 14 years). Citizen-responders must adhere to the general conditions. They need to self-declare absence of a criminal record, but declarations are not checked.

Switzerland, Region of Fribourg

(N = 225.500)

24 h/7

APP

GPS

1. Confirming the response

2. Location of victim; location of AED; demographics (victim) and situational information

1. Get a local AED

1. Safety jacket

Yes trained for CPR including use of an AED; Every two years

In an online system: Citizen responders must create an account in the app

Citizen-responder must complete a feedback sheet. Dependent of the answers, the foundation will contact the responder by phone. Sometimes citizen-responders can have immediately feedback from the EMS staff.

Yes, the foundation pay the replacement of AED consumable after intervention

Yes, citizen-responders have the possibility to call a psychological service

A minimum age of 18 years is required (of note: citizens are allowed to use an AED from age 14 years). Citizen-responders must adhere to the general conditions. They need to self-declare absence of a criminal record, but declarations are not checked.

  1. If citizen-responders are considered to be implemented in the total country, differences in density and characteristics, from city to city, may exist
  2. Abbreviations: as in Table 1
  3. aThe respondent specifically indicated that APP usage is not universal and (major) differences across the country exist
  4. bThere are four different APP-systems in Germany. Characteristics apply to region Marburg-Biedenkopf but may differ across the other regions