• Clément Derkenne, Daniel Jost, Florian Roquet, Paul Dardel, Romain Kedzierewicz, Alexandre Mignon, Stéphane Travers, Benoit Frattini, Laurent Prieux, Emmanuel Rozenberg, Xavier Demaison, John Gaudet, Félicité de Charry, Olivier Stibbe, Frédérique Briche, Frédéric Lemoine, Xavier Lesaffre, Olga Maurin, Eric Gauyat, Eric Faraon, Sabine Lemoine, and Bertrand Prunet.
• From the, Emergency Medical Department, Paris Fire Brigade, Paris, France.
• Acad Emerg Med. 2020 Oct 1; 27 (10): 951-962.

BackgroundOut-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).MethodsWe 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.ResultsApproximately 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.ConclusionsWe report that mobile smartphone technology was associated with OHCA survival through accelerated initiation of efficient CPR by first responders in a large urban area.© 2020 by the Society for Academic Emergency Medicine.

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