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Mobile Smartphone Technology Is Associated With Out‐of‐hospital Cardiac Arrest Survival Improvement: The First Year “Greater Paris Fire Brigade” Experience
Author(s) -
Derkenne Clément,
Jost Daniel,
Roquet Florian,
Dardel Paul,
Kedzierewicz Romain,
Mig Alexandre,
Travers Stéphane,
Frattini Benoit,
Prieux Laurent,
Rozenberg Emmanuel,
Demaison Xavier,
Gaudet John,
Charry Félicité,
Stibbe Olivier,
Briche Frédérique,
Lemoine Frédéric,
Lesaffre Xavier,
Maurin Olga,
Gauyat Eric,
Faraon Eric,
Lemoine Sabine,
Prunet Bertrand
Publication year - 2020
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/acem.13987
Subject(s) - medicine , cardiopulmonary resuscitation , odds ratio , automated external defibrillator , confidence interval , emergency medicine , cohort , return of spontaneous circulation , intervention (counseling) , confounding , emergency medical services , medical emergency , resuscitation , nursing
Background Out‐of‐hospital cardiac arrest (OHCA) remains associated with very high mortality. Accelerating the initiation of efficient cardiopulmonary resuscitation (CPR) is widely perceived as key to improving outcomes. The main goal was to determine whether identification and activation of nearby first responders through a smartphone application named Staying Alive (SA) can improve survival following OHCA in a large urban area (Paris). Methods We conducted a nonrandomized cohort study of all adults with OHCA managed by the Greater Paris Fire Brigade during 2018, irrespective of mobile application usage. We compared survival data in cases where SA did or did not lead to the activation of nearby first responders. During dispatch, calls for OHCA were managed with or without SA. The intervention group included all cases where nearby first responders were successfully identified by SA and actively contributed to CPR. The control group included all other cases. We compared survival at hospital discharge between the intervention and control groups. We analyzed patient data, CPR metrics, and first responders' characteristics. Results Approximately 4,107 OHCA cases were recorded in 2018. Among those, 320 patients were in the control group, whereas 46 patients, in the intervention group, received first responder–initiated CPR. After adjustment for confounders, survival at hospital discharge was significantly improved for patients in the intervention group (35% vs. 16%, adjusted odds ratio = 5.9, 95% confidence interval = 2.1 to 16.5, p < 0.001). All CPR metrics were improved in the intervention group. Conclusions We report that mobile smartphone technology was associated with OHCA survival through accelerated initiation of efficient CPR by first responders in a large urban area.