International CPR guidelines recommend that citizen responder systems should be introduced in all countries

International research also shows:
Early response to cardiac arrest saves lives

International studies emphasise the important role that early lifesaving interventions to a cardiac arrest can play in helping to save more lives. Since 2015, international guidelines have emphasised the responsibility of society to involve citizens in early CPR and defibrillation efforts before the healthcare system takes over. Now it’s recommended for all regions and countries.

The International Liaison Committee on Resuscitation (ILCOR) repeatedly undertakes detailed literary reviews of the scientific evidence ahead of upcoming international guidelines for CPR. In the year 2020, the ILCOR cast special attention on technologies which support early life-saving interventions such as citizen responder systems. ILCOR’s recommendation is to introduce such systems as a part of the ordinary care chain in all regions and countries. ILCOR is clear: ”We recommend that citizens/individuals who are in close proximity of a suspected out-of-hospital cardiac arrest event and who are willing to be engaged should be notified to the scene.”

The European Resuscitation Council’s (ERC) recommendations are the product of a comprehensive and systematic review of the research, which clearly shows that citizen responder systems save lives. The proportion of victims who receive early CPR before the ambulance arrives has a positive effect on survival rates.

In its new guidelines for CPR, the ERC recommends that systems which alert citizen responders to suspected cases of cardiac arrest outside of hospitals should be introduced in all regions and countries!

The system is in place in Sweden and Denmark

Sweden – more than 10 years of lifesaving

Heartrunners has been in use in Sweden since 2010. Swedish researchers at Karolinska Institutet were among the first in the world to demonstrate the positive effects of alerting citizen responders with CPR training when a person nearby suffers a suspected cardiac arrest. The results of a randomized controlled trial from 2015 show that the number of cardiac arrest patients receiving early CPR prior to ambulance arrival increased considerably.

Over the course of 2019, the Swedish PSAP service (SOS Alarm) alerted citizen responders to 1,230 suspected cardiac arrests within the Stockholm Region. In 47% of the cases, citizen responders arrived on the scene before the ambulance. Early intervention saves lives, and a number of victims were given better chances of survival as a result of early defibrillation.

Research in Sweden 

Research on the Heartrunner system in Sweden is currently being undertaken at the Karolinska Institutet’s Centre for Resuscitation Science, the KTH Royal Institute of Technology, Stockholm School of Economics, Linköping University and Linnaeus University.

Results from a randomised study in Sweden were first published back in 2015 in the New England Journal of Medicine. This study showed that in cases where citizen responders were first to arrive on the scene, the number of patients who received CPR increased by 32%.

Publications on the system

Dispatch of Volunteer Responders to Out-of-Hospital Cardiac Arrests

Mobile-Phone Dispatch of Laypersons for CPR in Out-of-Hospital Cardiac Arrest

A Smartphone Application for Dispatch of Lay Responders to Out-of-Hospital Cardiac Arrests

A Brisk Walk—Real-life Travelling Speed of Lay Responders in Out-of-Hospital Cardiac Arrest

Denmark runs nationwide

In 2020, Denmark became the first country in Europe to implement a common and nationwide system which goes by the name of TrygFonden Hjerteløber. Danish citizen responders can now provide help no matter where in the country they are and there are currently near 155,000 citizen responders nationwide. A recently published study from Copenhagen reports that the percentage of cardiac arrest victims who were defibrillated prior to the arrival of an ambulance tripled when volunteers were alerted and were first on the scene – from 7% to 21%. 

Research in Denmark

A scientific evaluation of the Heartrunner system is currently being undertaken at the University of Copenhagen in Denmark. An article published in the esteemed Journal of American College of Cardiology presents data from Copenhagen’s first year using a system whereby citizen responders are alerted to cases of suspected cardiac arrest.

In 42% of cardiac arrests during this period, one or several citizen responders were on the scene before the ambulance and able to start life-saving interventions. In the group where citizen responders were first on the scene, the researchers show that three times as many patients received defibrillation before the ambulance arrived (21.2% compared with 6.7%). 39 patients received defibrillation from voluntary citizen responders during this period and even though the patient material in the study were relatively small, the researchers were nonetheless able to demonstrate an increase in 30-day survival in cases where volunteers arrived on scene before the ambulance.

The International Liaison Committee on Resuscitation (ILCOR)… 

…was established in 1992 and is a forum for interdisciplinary collaboration between the world’s leading resuscitation organisations. Among other things, the ILCOR formulates international CPR guidelines and its vision is to saving more lives globally through resuscitation. www.ilcor.org

The ERC, the European
Resuscitation Council…

…is an interdisciplinary council for CPR and emergency health care founded in 1989. The ERC’s objective is to safeguard people’s lives by performing high-quality resuscitation for everyone. The ERC is a collective network of all the national CPR councils in Europe. www.erc.edu