Key result
Public responders cut OHCA response time by ~200 seconds vs EMS, but without improving survival.
Why the study?
First responders play an increasingly important role in out-of-hospital cardiac arrest management, but their response times and AED effectiveness need evaluation in the Swiss canton of Valais.
Does initial management by public responders improve response times and survival in out-of-hospital cardiac arrest compared to emergency medical services?
Observational (n=107)
Does initial management by public responders improve response times and survival in out-of-hospital cardiac arrest compared to emergency medical services?
Absolute Event Rate: 280% vs 480%
p-value: p=0.019
Public responders significantly reduce the time to on-site arrival for out-of-hospital cardiac arrest compared to traditional emergency medical services, although detecting a survival benefit may require larger cohorts.
Public responder first arrival shortens response times without survival benefit in out-of-hospital cardiac arrest; leaves open whether this extends to improved outcomes.
STUDY AIMS: Cardiac arrest is a condition with a high mortality rate, with most cases occurring outside hospital. First responders (defined as public responders in our study) play an increasingly important role in management through the early initiation of cardiopulmonary resuscitation and defibrillation. Several studies have shown that the involvement of public responders can result in faster initiation of resuscitation and increased survival. This study evaluated the management of out-of-hospital cardiac arrest by public responders and the effectiveness of the FRED-PA1 automated external defibrillator (AED) available in the canton of Valais, Switzerland. METHODS: This was a retrospective study including consecutive cases of out-of-hospital cardiac arrest occurring between January 2021 and December 2023 in the canton of Valais. Response times of public responders and emergency medical services (EMS) were evaluated, along with initial rhythms, survival, and the performance and safety of the available AEDs. RESULTS: A total of 107 patients were included in the study. In 68% of cases, a public responder arrived at the scene first, with a significantly shorter interval between emergency call and on-site arrival compared with EMSs (p = 0.019). Ventricular fibrillation was more frequent in the EMS group than the public responders group (35 vs 23%) (non-significant [NS]). Survival on arrival at hospital was 19% in the public responder group and 24% in the EMS group (NS). Survival to hospital discharge was 9.6% in the public responder group and 15% in the EMS group (NS). Concerning the AEDs, the rhythm recognition algorithm was deemed to be effective and consistent with current recommendations. CONCLUSION: This retrospective study demonstrates the key role played by public responders, who are frequently the first to arrive at the scene of out-of-hospital cardiac arrests. The FRED-PA1 AED algorithm meets the standards in the literature. However, ongoing prospective studies will highlight and optimise the role of public responders in out-of-hospital cardiac arrests.
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Kanthasamy et al. (2026) conducted an observational in Out-of-hospital cardiac arrest (n=107). First arrival by public responders vs. First arrival by emergency medical services (EMS) was evaluated on Response time (interval between emergency call and arrival at the scene in seconds) (p=0.019). First arrival by public responders significantly shortened response times for out-of-hospital cardiac arrest compared to emergency medical services (280 vs 480 seconds), without improving survival.
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