Psychological impact on first responders dispatched to out-of-hospital cardiac arrest via smartphone alerting system: A longitudinal survey-based study

Background

Smartphone alerting systems designed to dispatch volunteer first responders to out-of-hospital cardiac arrest cases are progressing rapidly. Recently, growing attention has been given to understanding the impact of these operations on first responders, with a particular focus on safeguarding them from possible psychological challenges. This study investigates the psychological stress experienced by first responders following their involvement in an operation, analyzing specific stress factors to enhance opportunities for psychological support.

Methods

A two-stage questionnaire (Q1 and Q2) survey was conducted, with surveys administered one and four weeks after dispatched first responder arrived at the scene between October 9, 2023, and January 23, 2024. Screening questions based on the FAUST study assessed psychological stress, with ≥4 positive responses indicating at-risk individuals. Personal and operational variables were analyzed for their correlation with stress levels for identifying affected first responder. The study was approved by the Freiburg Ethics Committee (DRKS00032958).

Results

The response rates for the triggered questionnaires were 190/324 (59%) for Q1 and 132/322 (41%) for Q2. Fewer than 1% answered ≥4 screening questions positively, indicating a low measured prevalence of psychological stress. Situations involving resuscitation or already deceased patients but also first responders’ feelings of insecurity were identified as significant factors of possible psychological stress, while regular CPR training appeared to significantly reduce the likelihood of stress.

Conclusions

First responders who volunteer for such roles frequently encounter challenging situations. However, psychological stress is rarely reported. Integrating mechanisms into smartphone alerting systems to identify stress indicators and provide accessible support is essential.