title: Psychological impact on dispatched local lay rescuers performing bystander cardiopulmonary resuscitation.
abstract: OBJECTIVE
  We studied the short-term psychological impact and post-traumatic stress disorder (PTSD)-related symptoms in lay rescuers performing cardiopulmonary resuscitation (CPR) after a text message (TM)-alert for out-of-hospital-cardiac arrest, and assessed which factors contribute to a higher level of PTSD-related symptoms.
  
  
  METHODS
  The lay rescuers received a TM-alert and simultaneously an email with a link to an online questionnaire. We analyzed all questionnaires from February 2013 until October 2014 measuring the short-term psychological impact. We interviewed by telephone all first arriving lay rescuers performing bystander CPR and assessed PTSD-related symptoms with the Impact of Event Scale (IES) 4-6 weeks after the resuscitation. IES-scores 0-8 reflected no stress, 9-25 mild, 26-43 moderate, and 44-75 severe stress. A score ≥ 26 indicated PTSD symptomatology.
  
  
  RESULTS
  Of all alerted lay rescuers, 6572 completed the online questionnaire. Of these, 1955 responded to the alert and 507 assisted in the resuscitation. We interviewed 203 first arriving rescuers of whom 189 completed the IES. Of these, 41% perceived no/mild short-term impact, 46% bearable impact and 13% severe impact. On the IES, 81% scored no stress and 19% scored mild stress. None scored moderate or severe stress. Using a multivariable logistic regression model we identified three factors with an independent impact on mild stress level: no automated external defibrillator connected by the lay rescuer, severe short-term impact, and no (very) positive experience.
  
  
  CONCLUSIONS
  Lay rescuers alerted by text messages, do not show PTSD-related symptoms 4-6 weeks after performing bystander CPR, even if they perceive severe short-term psychological impact.
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: j.a.zijlstra@amc.nl.
authors.forename: Jolande A
authors.initials: JA
authors.lastname: Zijlstra
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Stefanie G
authors.initials: SG
authors.lastname: Beesems
authors.affiliation: Clinical Research Unit, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Rob J
authors.initials: RJ
authors.lastname: De Haan
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Rudolph W
authors.initials: RW
authors.lastname: Koster
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000523:psychology* / Q000706:statistics & numerical data; D003256:Community Participation / Q000706:statistics & numerical data*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D058996:Quality Improvement; D012042:Registries; D018570:Risk Assessment / Q000379:methods*; D011795:Surveys and Questionnaires; D015996:Survival Rate / Q000639:trends; D013689:Telephone; D060145:Text Messaging; D061665:Time-to-Treatment; D016896:Treatment Outcome
keywords: Cardiopulmonary resuscitation; Impact; Lay rescuers; Out-of-hospital cardiac arrest; Post-traumatic stress disorder; Text messages