Perceived threats and challenges experienced by first responders during their mission for an out-of-hospital cardiac arrest.

Aim: No study has systematically captured the perceived threat, discomfort or issues experienced by First Responders (FRs). We aimed to report the FRs' experience during a mission for an out-of-hospital cardiac arrest (OHCA) in a ten-year span.

Methods: We collected all the 40-items questionnaires filled out by the FRs dispatched in Ticino Region (Switzerland) from 01/10/2010 to 31/12/2020. We compared results between FRs alerted by SMS or APP and between professional and citizen FRs.

Results: 3391 FRs filled the questionnaire. The OHCA information was considered complete more frequently by FRs alerted by APP (85.6% vs 76.8%, p < 0.001), but a challenge in reaching the location was more frequent (15.5% vs 11.4%, p < 0.001), mainly due to wrong GPS coordinate. The FRs initiated/participated in resuscitation in 64.6% and used an AED in 31.9% of OHCAs, without issue in 97.9%. FRs reported a very high-level of satisfaction (97%) in EMS collaboration, but one-third didn't have the possibility to debrief. Citizen FRs used AED more frequently than professional FRs (34.6% vs 30.7%, p < 0.01), but experienced more often difficulties in performing CPR (2.6% vs 1.2%, p = 0.02) and wore more in need to debrief (19.7% vs 13%, p < 0.01).

Conclusions: We provide a unique picture from the FRs' point of view during a real-life OHCA reporting high-level of satisfaction, great motivation but also the need of systematic debrief. We identified areas of improvements including geolocation accuracy, further training on AED use and support program dedicated to citizen FRs.