Rama A Salhi1, Stuart Hammond2, Jessica L Lehrich3, Michael O'leary4, Neil Kamdar4, Christine Brent5, Carlos F Mendes de Leon2, Peter Mendel6, Christopher Nelson6, Bill Forbush7, Robert Neumar5, Brahmajee K Nallamothu8, Mahshid Abir9. 1. Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, United States; Acute Care Research Unit, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States. Electronic address: rsalhi@umich.edu. 2. Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, United States. 3. University of Michigan, Ann Arbor, MI, United States. 4. Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States. 5. Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, United States. 6. RAND Corporation, Santa Monica, CA, United States. 7. City of Alpena Fire Department, Alpena County EMS, Alpena, MI, United States. 8. Division of Cardiovascular Diseases and the Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States. 9. Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, United States; Acute Care Research Unit, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States; RAND Corporation, Santa Monica, CA, United States.
Abstract
OBJECTIVE: Fire and police first responders are often the first to arrive in medical emergencies and provide basic life support services until specialized personnel arrive. This study aims to evaluate rates of fire or police first responder-initiated cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use, as well as their associated impact on out-of-hospital cardiac arrest (OHCA) outcomes. METHODS: We completed a secondary data analysis of the MI-CARES registry from 2014 to 2019. We reported rates of CPR initiation and AED use by fire or police first responders. Multilevel modeling was utilized to evaluate the relationship between fire/police first responder-initiated interventions and outcomes of interest: ROSC upon emergency department arrival, survival to hospital discharge, and good neurologic outcome. RESULTS: Our cohort included 25,067 OHCA incidents. We found fire or police first responders initiated CPR in 31.8% of OHCA events and AED use in 6.1% of OHCA events. Likelihood of sustained ROSC on ED arrival after CPR initiated by a fire/police first responder was not statistically different as compared to EMS initiated CPR (aOR 1.01, CI 0.93-1.11). However, fire/police first responder interventions were associated with significantly higher odds of survival to hospital discharge and survival with good neurologic outcome (aOR 1.25, 95% CI 1.08-1.45 and aOR 1.40, 95% CI 1.18-1.65, respectively). Similar associations were see when examining fire or police initiated AED use. CONCLUSIONS: Fire or police first responders may be an underutilized, potentially powerful mechanism for improving OHCA survival. Future studies should investigate barriers and opportunities for increasing first responder interventions by these groups in OHCA.
OBJECTIVE: Fire and police first responders are often the first to arrive in medical emergencies and provide basic life support services until specialized personnel arrive. This study aims to evaluate rates of fire or police first responder-initiated cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use, as well as their associated impact on out-of-hospital cardiac arrest (OHCA) outcomes. METHODS: We completed a secondary data analysis of the MI-CARES registry from 2014 to 2019. We reported rates of CPR initiation and AED use by fire or police first responders. Multilevel modeling was utilized to evaluate the relationship between fire/police first responder-initiated interventions and outcomes of interest: ROSC upon emergency department arrival, survival to hospital discharge, and good neurologic outcome. RESULTS: Our cohort included 25,067 OHCA incidents. We found fire or police first responders initiated CPR in 31.8% of OHCA events and AED use in 6.1% of OHCA events. Likelihood of sustained ROSC on ED arrival after CPR initiated by a fire/police first responder was not statistically different as compared to EMS initiated CPR (aOR 1.01, CI 0.93-1.11). However, fire/police first responder interventions were associated with significantly higher odds of survival to hospital discharge and survival with good neurologic outcome (aOR 1.25, 95% CI 1.08-1.45 and aOR 1.40, 95% CI 1.18-1.65, respectively). Similar associations were see when examining fire or police initiated AED use. CONCLUSIONS: Fire or police first responders may be an underutilized, potentially powerful mechanism for improving OHCA survival. Future studies should investigate barriers and opportunities for increasing first responder interventions by these groups in OHCA.
Authors: Seth C Hawkins; Alan H Shapiro; Adrianne E Sever; Theodore R Delbridge; Vincent N Mosesso Journal: Resuscitation Date: 2006-12-06 Impact factor: 5.262
Authors: Per Nordberg; Jacob Hollenberg; Mårten Rosenqvist; Johan Herlitz; Martin Jonsson; Hans Järnbert-Petterson; Sune Forsberg; Tobias Dahlqvist; Mattias Ringh; Leif Svensson Journal: Eur Heart J Acute Cardiovasc Care Date: 2014-04-16
Authors: Mahshid Abir; Sydney Fouche; Jessica Lehrich; Jason Goldstick; Neil Kamdar; Michael O'Leary; Christopher Nelson; Peter Mendel; Wilson Nham; Claude Setodji; Robert Domeier; Anthony Hsu; Theresa Shields; Rama Salhi; Robert W Neumar; Brahmajee K Nallamothu Journal: Resuscitation Date: 2020-12-08 Impact factor: 5.262
Authors: Jacob Hollenberg; Gabriel Riva; Katarina Bohm; Per Nordberg; Robert Larsen; Johan Herlitz; Hans Pettersson; Mårten Rosenqvist; Leif Svensson Journal: Eur Heart J Date: 2009-05-27 Impact factor: 29.983