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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, RegionActive systemMethod to activateLocation determination1. Response neededRole onsceneEquipmentTraining; FrequencyRegistrationFeedbackFinancial assistanceEmotional supportOther requirements to become a citizen-responder
2. Information provided by dispatcher
Austria
(N = 8.220.000)
24 h/7Standard communication system; SMS; Pager; APPGPS1. 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; AnnuallyIn 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-respondersYes: equipment and AED related disposablesYesA minimum of 18 years for the citizen-responders is required
Czech Republic Hradec Kralove Region
(N = 550.804)
24 h/7SMS; APPGPS1. 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 neededIn an online system: SW KISS SHARP (new name: O2 SOS), registration and information at fr.zzskhk.czLetter of thanksYes: safety vest, pocket mask, until 2017 also smartphoneYes, critical incident stress management available on requestA 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/7APPGPS1. 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. AEDNot required but strongly recommendedIn an online system: In the app serverVia mail and social media when asked forNoYes, critical incident stress management available on requestA minimum of 18 years for the citizen-responders is required
Denmark, Region Zealand, Region South
(N = 2.056.025)
24 h/7APPGPS1. 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. AEDYes trained for CPR including use of an AED; at least a 4 h CPR training courseIn an online system: In the app serverVia mail and social media when asked forNoYes, critical incident stress management available on requestA 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/7APPGPS and Address1. 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; AnnuallyIn an online system: In house databaseCitizen-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 EMSNoYesEach 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)
24/7SMS; APPGPS1. 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; AnnuallyIn an online system: In the app server/German Red CrossNoNoYes, they can choose to contact a special team for debriefingA minimum age of 18 years for the responders is required
Ireland
(N = 4.830.000)
24 h/7SMSNot determined1. 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; MonthlyAuthorisation granted by Ambulance OfficerCitizen-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-respondersReplacement of consumable equipmentYesA 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/7APPGPS1. 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
NoneYes trained for CPR including use of an AED; Bi-annuallyIn an online system: https://www.118er.it/dae/The responder manager sends an email to collect feedback by mail (but is not a routine)NoNoNo requirements
Hungary
(N = 9.800.000)
24 h/7Standard communication system; APPGPS1. 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. AEDNot required; There is not any training for them, it depends on the citizen.In an online system: Szív city (szivcity.hu)NoneNoNoNo requirements
The Netherlands Except Amsterdam
(N = 15.835350)
24 h/7SMS; APPGPS; Address1. 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. AEDYes trained for CPR including use of an AED; AnnuallyIn an online system: Hartslag.nuNoneNoHartslag.nu asks for an evaluation after the eventA 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)
NRSMSGPS1. 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. AEDYes trained for CPR including use of an AED; Only trained onceNRActivity is described in the annual reportNoInformal emotional support from Ambulance Service StaffA minimum age of 16 years for the citizen-responders is required
Sweden, Norrbotten County
(N = 251.295)
24 h/7SMSTriangulation by telephone towers1. No response is required
2. Location of victim
1. Perform CPRNoneYes trained for CPR including use of an AED; Responders should be educated but no specific follow up is doneIn an online system: https://www.mobilraddare.se/NRYes, please describe the type of assistance given: not specifiedYes, if requested they can contact the project via email/telephoneA minimum age of 18 years is required and no dispatch to children < 8 years
Sweden, Region western Sweden
(N = 2.016.000)
During daytime: 07:00–22:59SMSGPS1. 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
NoneYes trained for CPR including use of an AED; All should be trained once. The repetitions courses differs between individualsDirectly in the APPNoneNoYes, 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: 07:00–22:59SMS; APPGPS1. 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
NoneYes trained for CPR including use of an AED; Only trained onceIn an online system: Register directly via applicationVia mail and social media when asked forNoYes, 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 timeStandard communication systemGPS1. 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 programmeIn 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 themCitizen-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 themYes: 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 attendanceYesA 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/7APPNot determined1. Confirming the response
2. Location of victim; location of AED; demographic and situational information
1. Get a local AED; 2. Connect a breathing mask1. Safety jacketYes trained for CPR including use of an AED; Bi-annuallyIn 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 respondersNoYes, 24 h/7 days team of psychological counsellorsA 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/7APPGPS1. Confirming the response
2. Location of victim; location of AED; demographics (victim) and situational information
1. Get a local AED1. Safety jacketYes trained for CPR including use of an AED; Every two yearsIn an online system: Citizen responders must create an account in the appCitizen-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 interventionYes, citizen-responders have the possibility to call a psychological serviceA 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