• Sabine Nabecker, Matthias Theodorou, Sören Huwendiek, Nina Kasper, and Robert Greif.
• From the Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland (S-N, M-T, R-G), ERC Research NET (S-N, R-G), Department for Assessment and Evaluation, Institute for Medical Education Bern, University of Bern, Bern (S-H), Department of Anaesthesiology and Intensive Care Medicine, Spital Limattal, Schlieren, Switzerland (N-K) and School of Medicine, Sigmund Freud University Vienna, Vienna, Austria (R-G).
• Eur J Anaesthesiol. 2021 Oct 1; 38 (10): 1096-1104.

BackgroundFast delivery of high-quality cardiopulmonary resuscitation is crucial in improving patient outcome after out of hospital cardiac arrest. First responders (trained laypersons) are dispatched to shorten time to basic life support and can be organised in groups or individually.ObjectiveA comparison of factors enabling or impairing first responders' engagement in groups and as individuals are unknown. Therefore, we investigated these factors.DesignQualitative comparison.SettingWe set up six focus groups from March to June 2017 in the Canton of Bern, Switzerland. Thirteen group and 13 individual first responders participated.InterventionInterviews were audio-recorded, transcribed, coded and analysed following a thematic analytic approach. Two researchers coded the transcripts separately, identified, discussed and adjusted categories, themes and subthemes.ResultsFactors supporting first responders' engagement are: additional training, support from peers and society, satisfaction of personal desires (all important for all first responders), interdisciplinary collaboration (important for group first responders).Factors impairing first responders' engagement are: individual first responders lack training opportunities and collaboration, individual first responders lack support from peers and society, all first responders report lack of medical knowledge/skills and technical problems, confidentiality issues, legal insecurity and ethical concerns bother all first responders, intimidation by 'professional first responders' and professional burden. First responders organised in groups benefit from more training, enhanced peer support and collaboration with other groups. Individual first responders lack training opportunities and collaboration with emergency medical services.ConclusionTeam spirit and peer-support engages group first responders, whereas individual first responders are impaired by lack of social support. Involvement with society triggers both first responder types to become and stay first responders. As first responders in groups have substantial additional benefits, enhancing such groups might strengthen current first responder systems.Copyright © 2020 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited.

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