title: Early cardiopulmonary resuscitation and use of Automated External Defibrillators by laypersons in out-of-hospital cardiac arrest using an SMS alert service.
abstract: OBJECTIVE
  To evaluate an SMS service (SMS=short message service=text message) with which laypersons are alerted to go to patients with suspected out-of-hospital cardiac arrest and perform early cardiopulmonary resuscitation (CPR) and use an Automated External Defibrillator (AED). This study is the first to report on a program in which an emergency medical service (EMS) is able to alert citizens by sending them SMS messages on their mobile phone.
  
  
  METHODS
  Web-based questionnaires were completed by laypersons who were sent an alert by the AED-Alert system between February 1, 2010 and April 30, 2010. Questions concerned the process of training, receiving alerts, actions taken and follow-up care.
  
  
  RESULTS
  AED-Alert was activated for 52 patients suspected of cardiac arrest, sending 3227 alerts to 2287 laypersons. Out of 2168 eligible laypersons 1679 (77%) completed 2098 questionnaires, one for each alert. Action was taken in only 579 alerts. Laypersons were not in the patient's vicinity (41%), noticed alerts too late (35%), or other reasons (24%). In 298 alerts laypersons faced problems with retrieving AEDs (51%), finding addresses (29%), traffic (5%), or other (15%). Aid was provided in 75 alerts, involving 47 patients. Laypersons started early CPR and defibrillation (49%), assisted EMS personnel (52%), or took care of family (39%). Laypersons arrived before EMS personnel in 21 patients, started CPR and defibrillation in 18, and assisted EMS personnel in 9 patients.
  
  
  CONCLUSIONS
  Improvements of the SMS alert service by laypersons, the EMS, and through technical adjustments, could increase the number of laypersons who provide early aid.
authors.affiliation: University of Twente, Department of Health Technology and Services Research, The Netherlands.
authors.forename: Annemieke C
authors.initials: AC
authors.lastname: Scholten
authors.forename: Jeannette G
authors.initials: JG
authors.lastname: van Manen
authors.forename: Wim E
authors.initials: WE
authors.lastname: van der Worp
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Ijzerman
authors.forename: Carine J M
authors.initials: CJ
authors.lastname: Doggen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000295:instrumentation; D047548:Defibrillators; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D013997:Time Factors; D055815:Young Adult