scholarly journals Smartphone Based Alerting of First Responders During The COVID-19 Pandemic

2020 ◽  
Author(s):  
Julian Ganter ◽  
Domagoj Damjanovic ◽  
Georg Trummer ◽  
Hans-Jörg Busch ◽  
Klemens Baldas ◽  
...  
Keyword(s):  
Online Survey ◽  
Life Support ◽  
First Responders ◽  
Alert System ◽  
First Responder ◽  
Protective Measures ◽  
Lay Persons ◽  
Free Interval ◽  
Charity Organization ◽  
Alerting Systems

Abstract Background: Smartphone Alerting Systems (SAS) potentially reduce the resuscitation-free interval. Many of these systems invite lay persons, who a have been trained in Basic Life Support (BLS). The Freiburg alert system Region of Lifesavers (Region der Lebensretter, RDL) only registers first responders with a professional background (i.e. paramedics, nurses, physicians, medical students) and volunteers with at least 48 units training in emergency medicine. Here we describe the evolution of the RDL system during the pandemic.Methods: Due to a lack of personal protective equipment (PPE), the alert system had been stopped at the beginning of the COVID 19 pandemic on March 16th, 2020.The board of the charity organization operating RDL decided to design a concept for a safe restart. Following the raise of 34,000 Euros of private funds, 1,000 backpacks were equipped with FFP-2 mask, gloves, protective gown, safety glasses, mouth-nose protection, airway filter and ventilation bag/mask. Furthermore, the algorithm for first responders was adapted according to the ERC COVID guidelines. An online survey regarding volunteers’ willingness to help under different protective measures before, during and after the pandemic was conducted.Results: The system was restarted on May 26th, 2020. The number of volunteers newly registering for the system remained unchanged between 10 – 71 per month after restart of the system. The proportions of alarms with at least one first responder accepting among all activations of the system remained at approximately 50%, assuming that the volunteers being equipped with PPE felt safe during the COVID-19 pandemic. This was also confirmed by the results of the survey.Conclusions: During the ongoing pandemic, it is important to keep well-established first responder systems active, which can shorten the resuscitation-free interval. When PPE is provided for first responders, the readiness of the volunteers to remain active in the SAS is high.

scholarly journals Smartphone Based Alerting of First Responders During the COVID-19 Pandemic

2021 ◽  
Author(s):  
Julian Ganter ◽  
Domagoj Damjanovic ◽  
Georg Trummer ◽  
Hans-Jörg Busch ◽  
Klemens Baldas ◽  
...  
Keyword(s):  
Online Survey ◽  
Response Rate ◽  
First Responders ◽  
Standard Operating Procedure ◽  
European Resuscitation Council ◽  
Alarm Response ◽  
Free Interval ◽  
Survey Results ◽  
Potential Risks ◽  
Alerting Systems

Abstract Background: Smartphone Alerting Systems (SAS) for first responders potentially shorten the resuscitation-free interval of patients with acute cardiac arrest. During the COVID-19 pandemic, many systems were suspended due to potential risks for the responders. Therefore, a COVID-19 concept for the SAS in Freiburg/Germany was established and evaluated. Methods: Due to the pandemic, SAS was stopped in March 2020. A concept for a safe restart was elaborated with provision of a set with ventilation bag/mask, airway filter and personal protective equipment (PPE) for every volunteer. A standard operating procedure followed the COVID-19 guidelines of the European Resuscitation Council (ERC). Willingness of the participants to respond alarms during the pandemic was investigated using an online survey. Results: The system was restarted in May 2020. The willingness to respond to alarms was lower during the pandemic without PPE. It remained lower than before the pandemic when the volunteers had been equipped with PPE, but the alarm response rate remained at approximately 50% during the ongoing pandemic. Conclusions: When volunteers are equipped with PPE, the operation of a SAS does not need to be paused, and the willingness to respond remains high among first responders.

scholarly journals Smartphone Based Alerting of First Responders During the COVID-19 Pandemic

2021 ◽  
Author(s):  
Julian Ganter ◽  
Domagoj Damjanovic ◽  
Georg Trummer ◽  
Hans-Jörg Busch ◽  
Klemens Baldas ◽  
...  
Keyword(s):  
Online Survey ◽  
Response Rate ◽  
First Responders ◽  
Standard Operating Procedure ◽  
European Resuscitation Council ◽  
Alarm Response ◽  
Free Interval ◽  
Survey Results ◽  
Potential Risks ◽  
Alerting Systems

Abstract Background Smartphone Alerting Systems (SAS) for first responders potentially shorten the resuscitation-free interval of patients with acute cardiac arrest. During the COVID-19 pandemic, many systems were suspended due to potential risks for the responders. Therefore, a COVID-19 concept for the SAS in Freiburg/Germany was established and evaluated. Methods Due to the pandemic, SAS was stopped in March 2020. A concept for a safe restart was elaborated with provision of a set with ventilation bag/mask, airway filter and personal protective equipment (PPE) for every volunteer. A standard operating procedure followed the COVID-19 guidelines of the European Resuscitation Council (ERC). Willingness of the participants to respond alarms during the pandemic was investigated using an online survey. Results The system was restarted in May 2020. The willingness to respond to alarms was lower during the pandemic without PPE. It remained lower than before the pandemic when the volunteers had been equipped with PPE, but the alarm response rate remained at approximately 50% during the ongoing pandemic. Conclusions When volunteers are equipped with PPE, the operation of a SAS does not need to be paused, and the willingness to respond remains high among first responders.

Trained Lay First Responders Reduce Trauma Mortality: A Controlled Study of Rural Trauma in Iraq

2010 ◽  
Vol 25 (6) ◽  
pp. 533-539 ◽  
Author(s):  
Mudhafar Karim Murad ◽  
Hans Husum
Keyword(s):  
Life Support ◽  
Trauma System ◽  
First Responders ◽  
Severe Trauma ◽  
Controlled Study ◽  
Case Control Studies ◽  
First Responder ◽  
Trauma Outcomes ◽  
Randomized Clinical Study ◽  
Transit Times

AbstractIntroduction:Recent studies demonstrate that early, in-field, basic life support by paramedics improves trauma survival where prehospital transport times are long. So far, no case-control studies of the effect of layperson trauma first responders have been reported. It was hypothesized that trained layperson first responders improve trauma outcomes where prehospital transit times are long.Methods:A rural prehospital trauma system was established in the mine and war zones in Iraq, consisting of 135 paramedics and 7,000 layperson trauma first responders in the villages. In a non-randomized clinical study, the outcomes of patients initially managed in-field by first-responders were compared to patients not receiving first-responder support.Results:The mortality rate was significantly lower among patients initially managed in-field by first responders (n = 325) compared to patients without first-responder support (n = 1,016), 9.8% versus 15.6%, 95% CI = 1.3−10.0%.Conclusions:Trained layperson first responders improve trauma outcomes where prehospital evacuation times are long. This finding demonstrates that simple interventions done early—by any type of trained care provider—are crucial for trauma survival. Where the prevalence of severe trauma is high, trauma first-responders should be an integral element of the trauma system.

scholarly journals Pre-hospital advanced life support resuscitation – a curriculum for pre-hospital education

2020 ◽  
Vol 17 ◽  
Author(s):  
David Reid ◽  
Moira Sim ◽  
Shelley Beatty ◽  
Hugh Grantham ◽  
Mike Gale
Keyword(s):  
Healthcare Professionals ◽  
Life Support ◽  
Hospital Setting ◽  
Advanced Life Support ◽  
First Responders ◽  
Evidence Base ◽  
Hospital Environment ◽  
Lay Persons ◽  
Resource Limited ◽  
Interprofessional Healthcare

IntroductionThere is a broad evidence base to support advanced life support (ALS) education for healthcare professionals being structured, realistic and inclusive of a range of human factors. This paper outlines a curriculum for ALS resuscitation education for providers working in the pre-hospital or resource-limited settings. The focus on pre-hospital ALS education is important because actions taken by pre-hospital healthcare professionals have a critical impact on the likelihood of patient survival.MethodsThe pre-hospital ALS curriculum developed in this research was derived from a survey and interviews with pre-hospital healthcare professionals and first responders, and input from resuscitation, medical and education experts. Following completion of the interviews an expert panel of resuscitation experts was consulted. ResultsInformation collected indicated that a pre-hospital ALS course should follow current recommendations of the Australian Resuscitation Council and that the course should be delivered in a mixed mode comprising of online pre-reading and a quiz followed by one day of face-to-face teaching. Equipment should reflect that used in the pre-hospital environment and a pre-hospital ALS course should include scenarios relevant to the pre-hospital setting involving varying numbers of interprofessional healthcare teams as well as first responders and lay persons. Candidates should be assessed on a continual basis and certificates of participation be valid for 2 to 3 years. ConclusionTo improve pre-hospital resuscitation education and maximise the likelihood of patient survival, ALS education for pre-hospital providers should follow Australian Resuscitation Council guidelines, include pre-course reading, case studies and practical simulation in situations that are likely to be encountered by pre-hospital professionals.

Supporting the Mental Health and Well-Being of First Responders from Career to Retirement: A Scoping Review

2021 ◽  
pp. 1-6
Author(s):  
Erin Smith ◽  
Greg Dean ◽  
Lisa Holmes
Keyword(s):  
Mental Health ◽  
Scoping Review ◽  
Help Seeking ◽  
First Responders ◽  
Well Being ◽  
First Responder ◽  
Help Seeking Behaviors ◽  
Holistic Approaches ◽  
Pubmed Database ◽  
Health And Well Being

Abstract Introduction: First responders are at greater risk of mental ill health and compromised well-being compared to the general population. It is important to identify strategies that will be effective in supporting mental health, both during and after the first responder’s career. Methods: A scoping review was conducted using the PubMed database (1966 to October 1, 2020) and the Google Scholar database (October 1, 2020) using relevant search terms, truncation symbols, and Boolean combination functions. The reference lists of all relevant publications were also reviewed to identify further publications. Results: A total of 172 publications were retrieved by the combined search strategies. Of these, 56 met the inclusion criteria and informed the results of this overview paper. These publications identified that strategies supporting first responder mental health and well-being need to break down stigma and build resilience. Normalizing conversations around mental health is integral for increasing help-seeking behaviors, both during a first responder’s career and in retirement. Organizations should consider the implementation of both pre-retirement and post-retirement support strategies to improve mental health and well-being. Conclusion: Strategies for supporting mental health and well-being need to be implemented early in the first responder career and reinforced throughout and into retirement. They should utilize holistic approaches which encourage “reaching in” rather than placing an onus on first responders to “reach out” when they are in crisis.

scholarly journals COVID-19 symptoms and SARS-CoV-2 antibody positivity in a large survey of first responders and healthcare personnel, May-July 2020

2021 ◽  
Author(s):  
Lara J Akinbami ◽  
Lyle R Petersen ◽  
Samira Sami ◽  
Nga Vuong ◽  
Susan L Lukacs ◽  
...  
Keyword(s):  
First Responders ◽  
Healthcare Personnel ◽  
First Responder ◽  
Antibody Positivity ◽  
Large Survey

Abstract A SARS-CoV-2 serosurvey among first responder/healthcare personnel showed that loss of taste/smell was most predictive of seropositivity; percent seropositivity increased with number of COVID-19 symptoms. However, 22.9% with nine symptoms were seronegative, and 8.3% with no symptoms were seropositive. These findings demonstrate limitations of symptom-based surveillance and importance of testing.

scholarly journals Prehospital Triage by Lay Person First Responders: A Scoping Review and Proposal for a new Prehospital Triage Tool

2021 ◽  
pp. 1-11
Author(s):  
Wesley D Jetten ◽  
Jeroen Seesink ◽  
Markus Klimek
Keyword(s):  
Scoping Review ◽  
Life Support ◽  
First Responders ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Mass Casualty Incidents ◽  
Lay People ◽  
Online Databases ◽  
Healthcare Experience ◽  
Prehospital Triage

Abstract Objective: The primary aim of this study is to review the available tools for prehospital triage in case of mass casualty incidents and secondly, to develop a tool which enables lay person first responders (LPFRs) to perform triage and start basic life support in mass casualty incidents. Methods: In July 2019, online databases were consulted. Studies addressing prehospital triage methods for lay people were analyzed. Secondly, a new prehospital triage tool for LPFRs was developed. Therefore, a search for prehospital triage models available in literature was conducted and triage actions were extracted. Results: The search resulted in 6188 articles, and after screening, a scoping review of 4 articles was conducted. All articles stated that there is great potential to provide accurate prehospital triage by people with no healthcare experience. Based on these findings, and combined with the pre-existing prehospital triage tools, we developed a, not-yet validated, prehospital triage tool for lay people, which may improve disaster awareness and preparedness and might positively contribute to community resilience. Conclusion: The prehospital triage tool for lay person first responders may be useful and may help professional medical first responders to determine faster, which casualties most urgently need help in a mass casualty incident.

scholarly journals Comparison of the validity, perceived usefulness and usability of I-MeDeSA and TEMAS, two tools to evaluate alert system usability: a study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e050448
Author(s):  
Romaric Marcilly ◽  
Wu Yi Zheng ◽  
Regis Beuscart ◽  
Melissa T Baysari
Keyword(s):  
Human Factors ◽  
Convergent Validity ◽  
Perceived Usefulness ◽  
Decision Makers ◽  
Free Text ◽  
Alert System ◽  
System Usability Scale ◽  
System Usability ◽  
Ethical Approval ◽  
Alerting Systems

IntroductionResearch has shown that improvements to the usability of medication alert systems are needed. For designers and decisions-makers to assess usability of their alert systems, two paper-based tools are currently available: the instrument for evaluating human-factors principles in medication-related decision support alerts (I-MeDeSA) and the tool for evaluating medication alerting systems (TEMAS). This study aims to compare the validity, usability and usefulness of both tools to identify their strengths and limitations and assist designers and decision-makers in making an informed decision about which tool is most suitable for assessing their current or prospective system.Methods and analysisFirst, TEMAS and I-MeDeSA will be translated into French. This translation will be validated by three experts in human factors. Then, in 12 French hospitals with a medication alert system in place, staff with expertise in the system will evaluate their alert system using the two tools successively. After the use of each tool, participants will be asked to fill in the System Usability Scale (SUS) and complete a survey on the understandability and perceived usefulness of each tool. Following the completion of both assessments, participants will be asked to nominate their preferred tool and relay their opinions on the tools. The design philosophy of TEMAS and I-MeDeSA differs on the calculation of a score, impacting the way the comparison between the tools can be performed. Convergent validity will be evaluated by matching the items of the two tools with respect to the usability dimensions they assess. SUS scores and answers to the survey will be statistically compared for I-MeDeSA and TEMAS to identify differences. Free-text responses in surveys will be analysed using an inductive approach.Ethics and disseminationEthical approval is not required in France for a study of this nature. The results will be published in a peer-reviewed journal.

744 A Quality Improvement Project on Timely Removal of Central Venous Catheters

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Devarakonda ◽  
P J Korula ◽  
S Kandasamy
Keyword(s):  
Online Survey ◽  
Blood Stream ◽  
Central Line ◽  
High Morbidity ◽  
Alert System ◽  
Improvement Project ◽  
Central Lines ◽  
Surgical Icu ◽  
Intervention Adherence ◽  
The Mean

Abstract Introduction Central Line-Associated Blood Stream Infections are associated with high morbidity and mortality. It is essential to ensure quality in insertion, maintenance, and timely removal of central lines. Our ICU follows a protocol to remove unused lines after five days. We have an electronic alert system to monitor these lines, and we wanted to audit its usage and improve its efficacy. Method This project was designed using QI methodology and was carried out in a Level III Surgical ICU. We implemented two PDSA cycles in August and December 2020. After the first cycle, an online survey was performed among ICU doctors to gauge their knowledge of the alert system and local protocols. Based on the above results, an educational session was carried out, showing a step-by-step guide to using the alert system, and a re-audit was done in December. Results The first cycle showed that alerts were created for only 17 (25%) of 68 lines. Also, the survey revealed that about 30% of doctors were unfamiliar with the alert system. After the intervention, adherence to the alert system increased to 65% (alerts for 41 of 63 lines). There was also a significant improvement in the mean number of central line days from 6.4 (SD = 3.1) to 4.2 (SD = 2.8) [P <  .05]. Conclusions It is crucial to monitor central lines, and simple educational sessions about local protocols can bring success in implementing sustainable change in quality. We suggest hospitals have systems to monitor the central lines and regularly audit their effectiveness.

Abstract 113: Signs of Perfusion During Cardiopulmonary Resuscitation as Noted by First Responders is Predictive of Good Neurologic Outcome in Cardiac Arrest

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Johanna C Moore ◽  
Michael Grahl ◽  
Tracy Marko ◽  
Ariel Blythe-Reske ◽  
Amber Lage ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Life Support ◽  
Cerebral Performance Category ◽  
First Responders ◽  
Small Sample ◽  
Neurologic Outcome ◽  
Discharge Data ◽  
Good Neurologic Outcome ◽  
Neurologically Intact

Background: Rates of neurologically intact survival after cardiac arrest remain abysmal. Neuro-prognostication intra-arrest is challenging, with few real-time factors that can be used to determine patient prognosis. During the implementation of a new cardiopulmonary resuscitation (CPR) protocol in a large urban pre-hospital system, first responders prospectively recorded the presence of signs of perfusion during CPR. Hypothesis: Positive signs of perfusion would be a predictor of a good neurologic outcome in this observational study, as defined by Cerebral Performance Category (CPC) Score of 1 or 2. Methods: Basic life support first responders (n = 420) and paramedics (n = 207) underwent training including didactic and hands-on sessions to learn the new protocol, which included active compression-decompression CPR with an impedance threshold device. In addition to patient demographics and circumstances of cardiac arrest, signs of perfusion during CPR were prospectively recorded and included improved color, pulse during CPR, gasping, and movement during CPR. Chart review was performed to determine CPC score at discharge. Data were analyzed using descriptive statistics and calculation of unadjusted odds ratios. Results: The new protocol began May 1, 2017. Cases from May 2017-November 2017 (n= 102) were reviewed, with complete data available for 96 patients (94%). The median age was 56 (range 25-97), 54/91 (59%) male, 43/102 (42%) witnessed, 31/90 (34%) shockable rhythm, and 51/102 (50%) receiving bystander CPR. Improved color during CPR was seen in 23/102 (23%), pulse during CPR in 17/102 (17%), gasping in 18/102 (18%), and movement during CPR in 5/102 (5%). Any sign of perfusion during CPR was seen in 47/102 (46%), and 13/96 (13.5%) had a CPC score of 1 or 2 at discharge. The unadjusted OR for any sign of perfusion during CPR for a CPC score of 1 or 2 was 26 (95% CI 3 - 213) and for any sign of perfusion during CPR for ROSC was 9 (95% CI 3 - 24). Conclusions: Positive signs of perfusion during CPR noted by first responders strongly predicted ROSC and neurologically intact survival in this small sample. This suggests the importance of prospectively recording signs of perfusion during resuscitation, and communicating these observations during transfer of care.

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