[Registration procedures in smartphone-based first responder alerting systems in Germany : A nationwide secondary data analysis with a local implementation example].

Abstract

Background: Smartphone-based first responder alert systems are a key component of the chain of survival in out-of-hospital cardiac arrest. In Germany, there are considerable regional differences in terms of qualification requirements and registration and approval processes. The impact of these barriers to access on the number of registered first responders has not yet been systematically investigated.

Methods: A retrospective secondary data analysis was performed based on freely available data. Ninety-nine regions with complete information on registration procedures, qualification requirements, and the number of registered first responders were included. In addition, the effect of voluntary 2 h short training courses on chest compressions on the subjective confidence of participants was examined in the Rheinisch-Bergisch district using a survey.

Results: At the time of data collection, a smartphone-based first responder alert system had been implemented in 45% of emergency medical service areas. The average registration rate was 0.246% of the population. Regions with self-registration procedures had significantly higher registration rates than regions with formal registration (0.267% vs. 0.152%; p < 0.001). In two regions with self-declaration only and no verification of proof, rates of up to 0.489% were achieved. In the local case study, 2217 first responders were registered, 40% of whom had first aid qualifications only. The short training course was associated with a significant increase in subjective safety.

Conclusion: Low-threshold registration procedures are associated with higher registration rates in smartphone-based first responder alert systems. Accompanying short training courses can apparently increase the subjective confidence of first responders. Reducing formal barriers to access could help improve the availability of volunteer first responders. However, the effects of lower barriers to access on the psychological stress of first responders and on patient outcomes are unclear.