title: Mobile-phone dispatch of laypersons for CPR in out-of-hospital cardiac arrest.
abstract: BACKGROUND
  Cardiopulmonary resuscitation (CPR) performed by bystanders is associated with increased survival rates among persons with out-of-hospital cardiac arrest. We investigated whether rates of bystander-initiated CPR could be increased with the use of a mobile-phone positioning system that could instantly locate mobile-phone users and dispatch lay volunteers who were trained in CPR to a patient nearby with out-of-hospital cardiac arrest.
  
  
  METHODS
  We conducted a blinded, randomized, controlled trial in Stockholm from April 2012 through December 2013. A mobile-phone positioning system that was activated when ambulance, fire, and police services were dispatched was used to locate trained volunteers who were within 500 m of patients with out-of-hospital cardiac arrest; volunteers were then dispatched to the patients (the intervention group) or not dispatched to them (the control group). The primary outcome was bystander-initiated CPR before the arrival of ambulance, fire, and police services.
  
  
  RESULTS
  A total of 5989 lay volunteers who were trained in CPR were recruited initially, and overall 9828 were recruited during the study. The mobile-phone positioning system was activated in 667 out-of-hospital cardiac arrests: 46% (306 patients) in the intervention group and 54% (361 patients) in the control group. The rate of bystander-initiated CPR was 62% (188 of 305 patients) in the intervention group and 48% (172 of 360 patients) in the control group (absolute difference for intervention vs. control, 14 percentage points; 95% confidence interval, 6 to 21; P<0.001).
  
  
  CONCLUSIONS
  A mobile-phone positioning system to dispatch lay volunteers who were trained in CPR was associated with significantly increased rates of bystander-initiated CPR among persons with out-of-hospital cardiac arrest. (Funded by the Swedish Heart-Lung Foundation and Stockholm County; ClinicalTrials.gov number, NCT01789554.).
authors.affiliation: From the Department of Medicine, Center for Resuscitation Science, Karolinska Institutet, Solna (M. Ringh, J.H., M.J., D.F., P.N., I.H.-A., G.R., L.S.), the Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Danderyd (M. Rosenqvist), and the Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset (H.J.-P.) - all in Stockholm.
authors.forename: Mattias
authors.initials: M
authors.lastname: Ringh
authors.forename: Mårten
authors.initials: M
authors.lastname: Rosenqvist
authors.forename: Jacob
authors.initials: J
authors.lastname: Hollenberg
authors.forename: Martin
authors.initials: M
authors.lastname: Jonsson
authors.forename: David
authors.initials: D
authors.lastname: Fredman
authors.forename: Per
authors.initials: P
authors.lastname: Nordberg
authors.forename: Hans
authors.initials: H
authors.lastname: Järnbert-Pettersson
authors.forename: Ingela
authors.initials: I
authors.lastname: Hasselqvist-Ax
authors.forename: Gabriel
authors.initials: G
authors.lastname: Riva
authors.forename: Leif
authors.initials: L
authors.lastname: Svensson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D040421:Cell Phone; D005260:Female; D040362:Geographic Information Systems; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D016037:Single-Blind Method; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology; D061665:Time-to-Treatment; D014838:Volunteers