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Number of community first responders needed for quick response times to cardiac arrest: a nationwide study.

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Τίτλος: Number of community first responders needed for quick response times to cardiac arrest: a nationwide study.
Συγγραφείς: Kjærulf V; Department of Clinical Medicine, University of Copenhagen, Denmark; Copenhagen University Hospital - Emergency Medical Services, Copenhagen, Denmark. Electronic address: victor.kjaerulf@regionh.dk., Shahriari P; Department of Clinical Medicine, University of Copenhagen, Denmark; Copenhagen University Hospital - Emergency Medical Services, Copenhagen, Denmark., Kjærholm S; Department of Clinical Medicine, University of Copenhagen, Denmark; Copenhagen University Hospital - Emergency Medical Services, Copenhagen, Denmark., Tingsgaard J; Department of Clinical Medicine, University of Copenhagen, Denmark; Copenhagen University Hospital - Emergency Medical Services, Copenhagen, Denmark., Sell M; Copenhagen University Hospital - Emergency Medical Services, Copenhagen, Denmark., Andelius L; Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Denmark; Copenhagen University Hospital - Emergency Medical Services, Copenhagen, Denmark., Hansen CM; Department of Clinical Medicine, University of Copenhagen, Denmark; Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Denmark; Copenhagen University Hospital - Emergency Medical Services, Copenhagen, Denmark., Folke F; Department of Clinical Medicine, University of Copenhagen, Denmark; Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Denmark; Copenhagen University Hospital - Emergency Medical Services, Copenhagen, Denmark.
Πηγή: Resuscitation [Resuscitation] 2026 Sep; Vol. 226, pp. 111200. Date of Electronic Publication: 2026 Jul 03.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Elsevier/north-Holland Biomedical Press Country of Publication: Ireland NLM ID: 0332173 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-1570 (Electronic) Linking ISSN: 03009572 NLM ISO Abbreviation: Resuscitation Subsets: MEDLINE
Imprint Name(s): Publication: Limerick : Elsevier/north-Holland Biomedical Press
Original Publication: London, Middlesex Pub. Co.
Ιατρικοί όροι (MeSH): Out-of-Hospital Cardiac Arrest*/therapy , Cardiopulmonary Resuscitation*/statistics & numerical data , Cardiopulmonary Resuscitation*/methods , Emergency Medical Services*/statistics & numerical data , Emergency Medical Services*/organization & administration , Time-to-Treatment*/statistics & numerical data, Denmark/epidemiology ; Defibrillators/statistics & numerical data ; Humans ; Time Factors ; Reaction Time
Περίληψη: Introduction: Current resuscitation guidelines recommend activating a community first responder (CFR) system for out-of-hospital cardiac arrest. Although such systems are widely implemented, evidence on how the number of available CFRs affects system performance is very limited. This study assessed how many available CFRs are required to consistently achieve CFR response times under 5 min.
Methods: Activations of the Danish nationwide CFR system from February 2018 to August 2024 were grouped by the number of available CFRs per 100,000 residents. Response times for the first-arriving CFR and the first-arriving CFR bringing an automated external defibrillator (AED) were calculated from the coordinates of moving CFRs.
Results: We analyzed 12,806 CFR system activations. As the number of available CFRs increased from 300-399 to 800-899 per 100,000 residents, the percentage of activations with a response time under 5 min for the first-arriving CFR increased from 33% to 46% (an absolute increase of 13%, 95% CI [5%, 21%]) and for the first-arriving CFR bringing an AED from 7% to 29% (an absolute increase of 23%, 95% CI [15%, 31%]).
Conclusion: The likelihood of CFR response times under 5 min increased significantly with the number of available CFRs. At around 800 available CFRs per 100,000 residents, a response time under 5 min for the first-arriving CFR was achieved in almost half of system activations, and for the first-arriving CFR bringing an AED in almost one-third of system activations. This shows the importance of recruiting enough CFRs to ensure quick response times.
(Copyright © 2026 Elsevier B.V. All rights reserved.)
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Victor Kjaerulf reports financial support was provided by TrygFonden. Persia Shahriari reports financial support was provided by TrygFonden. Sofie Kjaerholm reports financial support was provided by TrygFonden. Linn Andelius reports financial support was provided by TrygFonden. Jakob Tingsgaard reports financial support was provided by TrygFonden. Morten Sell reports financial support was provided by TrygFonden. Carolina Malta Hansen reports financial support was provided by TrygFonden. Fredrik Folke reports financial support was provided by TrygFonden. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Entry Date(s): Date Created: 20260703 Date Completed: 20260821 Latest Revision: 20260821
Update Code: 20260822
DOI: 10.1016/j.resuscitation.2026.111200
PMID: 42398848
Βάση Δεδομένων: MEDLINE
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  Data: Number of community first responders needed for quick response times to cardiac arrest: a nationwide study.
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  Data: <searchLink fieldCode="AU" term="%22Kjærulf+V%22">Kjærulf V</searchLink>; Department of Clinical Medicine, University of Copenhagen, Denmark; Copenhagen University Hospital - Emergency Medical Services, Copenhagen, Denmark. Electronic address: victor.kjaerulf@regionh.dk.<br /><searchLink fieldCode="AU" term="%22Shahriari+P%22">Shahriari P</searchLink>; Department of Clinical Medicine, University of Copenhagen, Denmark; Copenhagen University Hospital - Emergency Medical Services, Copenhagen, Denmark.<br /><searchLink fieldCode="AU" term="%22Kjærholm+S%22">Kjærholm S</searchLink>; Department of Clinical Medicine, University of Copenhagen, Denmark; Copenhagen University Hospital - Emergency Medical Services, Copenhagen, Denmark.<br /><searchLink fieldCode="AU" term="%22Tingsgaard+J%22">Tingsgaard J</searchLink>; Department of Clinical Medicine, University of Copenhagen, Denmark; Copenhagen University Hospital - Emergency Medical Services, Copenhagen, Denmark.<br /><searchLink fieldCode="AU" term="%22Sell+M%22">Sell M</searchLink>; Copenhagen University Hospital - Emergency Medical Services, Copenhagen, Denmark.<br /><searchLink fieldCode="AU" term="%22Andelius+L%22">Andelius L</searchLink>; Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Denmark; Copenhagen University Hospital - Emergency Medical Services, Copenhagen, Denmark.<br /><searchLink fieldCode="AU" term="%22Hansen+CM%22">Hansen CM</searchLink>; Department of Clinical Medicine, University of Copenhagen, Denmark; Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Denmark; Copenhagen University Hospital - Emergency Medical Services, Copenhagen, Denmark.<br /><searchLink fieldCode="AU" term="%22Folke+F%22">Folke F</searchLink>; Department of Clinical Medicine, University of Copenhagen, Denmark; Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Denmark; Copenhagen University Hospital - Emergency Medical Services, Copenhagen, Denmark.
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  Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22Elsevier%2Fnorth-Holland+Biomedical+Press%22">Elsevier/north-Holland Biomedical Press </searchLink><i>Country of Publication: </i>Ireland <i>NLM ID: </i>0332173 <i>Publication Model: </i>Print-Electronic <i>Cited Medium: </i>Internet <i>ISSN: </i>1873-1570 (Electronic) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%2203009572%22">03009572 </searchLink><i>NLM ISO Abbreviation: </i>Resuscitation <i>Subsets: </i>MEDLINE
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  Data: <searchLink fieldCode="MM" term="%22Out-of-Hospital+Cardiac+Arrest%22">Out-of-Hospital Cardiac Arrest*</searchLink>/<searchLink fieldCode="MM" term="%22Out-of-Hospital+Cardiac+Arrest+therapy%22">therapy</searchLink> <br /><searchLink fieldCode="MM" term="%22Cardiopulmonary+Resuscitation%22">Cardiopulmonary Resuscitation*</searchLink>/<searchLink fieldCode="MM" term="%22Cardiopulmonary+Resuscitation+statistics+%26+numerical+data%22">statistics & numerical data</searchLink> <br /><searchLink fieldCode="MM" term="%22Cardiopulmonary+Resuscitation%22">Cardiopulmonary Resuscitation*</searchLink>/<searchLink fieldCode="MM" term="%22Cardiopulmonary+Resuscitation+methods%22">methods</searchLink> <br /><searchLink fieldCode="MM" term="%22Emergency+Medical+Services%22">Emergency Medical Services*</searchLink>/<searchLink fieldCode="MM" term="%22Emergency+Medical+Services+statistics+%26+numerical+data%22">statistics & numerical data</searchLink> <br /><searchLink fieldCode="MM" term="%22Emergency+Medical+Services%22">Emergency Medical Services*</searchLink>/<searchLink fieldCode="MM" term="%22Emergency+Medical+Services+organization+%26+administration%22">organization & administration</searchLink> <br /><searchLink fieldCode="MM" term="%22Time-to-Treatment%22">Time-to-Treatment*</searchLink>/<searchLink fieldCode="MM" term="%22Time-to-Treatment+statistics+%26+numerical+data%22">statistics & numerical data</searchLink><br /><searchLink fieldCode="MH" term="%22Denmark%22">Denmark</searchLink>/<searchLink fieldCode="MH" term="%22Denmark+epidemiology%22">epidemiology</searchLink> ; <searchLink fieldCode="MH" term="%22Defibrillators%22">Defibrillators</searchLink>/<searchLink fieldCode="MH" term="%22Defibrillators+statistics+%26+numerical+data%22">statistics & numerical data</searchLink> ; <searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Time+Factors%22">Time Factors</searchLink> ; <searchLink fieldCode="MH" term="%22Reaction+Time%22">Reaction Time</searchLink>
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  Data: Introduction: Current resuscitation guidelines recommend activating a community first responder (CFR) system for out-of-hospital cardiac arrest. Although such systems are widely implemented, evidence on how the number of available CFRs affects system performance is very limited. This study assessed how many available CFRs are required to consistently achieve CFR response times under 5 min.<br />Methods: Activations of the Danish nationwide CFR system from February 2018 to August 2024 were grouped by the number of available CFRs per 100,000 residents. Response times for the first-arriving CFR and the first-arriving CFR bringing an automated external defibrillator (AED) were calculated from the coordinates of moving CFRs.<br />Results: We analyzed 12,806 CFR system activations. As the number of available CFRs increased from 300-399 to 800-899 per 100,000 residents, the percentage of activations with a response time under 5 min for the first-arriving CFR increased from 33% to 46% (an absolute increase of 13%, 95% CI [5%, 21%]) and for the first-arriving CFR bringing an AED from 7% to 29% (an absolute increase of 23%, 95% CI [15%, 31%]).<br />Conclusion: The likelihood of CFR response times under 5 min increased significantly with the number of available CFRs. At around 800 available CFRs per 100,000 residents, a response time under 5 min for the first-arriving CFR was achieved in almost half of system activations, and for the first-arriving CFR bringing an AED in almost one-third of system activations. This shows the importance of recruiting enough CFRs to ensure quick response times.<br /> (Copyright © 2026 Elsevier B.V. All rights reserved.)
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  Data: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Victor Kjaerulf reports financial support was provided by TrygFonden. Persia Shahriari reports financial support was provided by TrygFonden. Sofie Kjaerholm reports financial support was provided by TrygFonden. Linn Andelius reports financial support was provided by TrygFonden. Jakob Tingsgaard reports financial support was provided by TrygFonden. Morten Sell reports financial support was provided by TrygFonden. Carolina Malta Hansen reports financial support was provided by TrygFonden. Fredrik Folke reports financial support was provided by TrygFonden. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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