title: Lay persons alerted by mobile application system initiate earlier cardio-pulmonary resuscitation: A comparison with SMS-based system notification.
abstract: We compared the time to initiation of cardiopulmonary resuscitation (CPR) by lay responders and/or first responders alerted either via Short Message Service (SMS) or by using a mobile application-based alert system (APP).
  
  
  
  The Ticino Registry of Cardiac Arrest collects all data about out-of-hospital cardiac arrests (OHCAs) occurring in the Canton of Ticino. At the time of a bystander's call, the EMS dispatcher sends one ambulance and alerts the first-responders network made up of police officers or fire brigade equipped with an automatic external defibrillator, the so called "traditional" first responders, and - if the scene was considered safe - lay responders as well. We evaluated the time from call to arrival of traditional first responders and/or lay responders when alerted either via SMS or the new developed mobile APP.
  
  
  
  Over the study period 593 OHCAs have occurred. Notification to the first responders network was sent via SMS in 198 cases and via mobile APP in 134 cases. Median time to first responder/lay responder arrival on scene was significantly reduced by the APP-based system (3.5 [2.8-5.2]) compared to the SMS-based system (5.6 [4.2-8.5] min, p 0.0001). The proportion of lay responders arriving first on the scene significantly increased (70% vs. 15%, p<0.01) with the APP. Earlier arrival of a first responder or of a lay responder determined a higher survival rate.
  
  
  
  The mobile APP system is highly efficient in the recruitment of first responders, significantly reducing the time to the initiation of CPR thus increasing survival rates.
authors.affiliation: Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland. Electronic address: marialuce.caputo@cardiocentro.org.
authors.forename: Maria Luce
authors.initials: ML
authors.lastname: Caputo
authors.affiliation: Federazione Cantonale Ticinese Servizi Autoambulanze, Lugano, Switzerland.
authors.forename: Sandro
authors.initials: S
authors.lastname: Muschietti
authors.affiliation: Fondazione Ticino Cuore, Breganzona, Switzerland.
authors.forename: Roman
authors.initials: R
authors.lastname: Burkart
authors.affiliation: Fondazione Ticino Cuore, Breganzona, Switzerland.
authors.forename: Claudio
authors.initials: C
authors.lastname: Benvenuti
authors.affiliation: Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland.
authors.forename: Giulio
authors.initials: G
authors.lastname: Conte
authors.affiliation: Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland.
authors.forename: François
authors.initials: F
authors.lastname: Regoli
authors.affiliation: Fondazione Ticino Cuore, Breganzona, Switzerland.
authors.forename: Romano
authors.initials: R
authors.lastname: Mauri
authors.affiliation: Service of Biometry and Clinical Epidemiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Catherine
authors.initials: C
authors.lastname: Klersy
authors.affiliation: Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland.
authors.forename: Tiziano
authors.initials: T
authors.lastname: Moccetti
authors.affiliation: Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland.
authors.forename: Angelo
authors.initials: A
authors.lastname: Auricchio
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data*; D047548:Defibrillators; D004631:Emergency Medical Service Communication Systems / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D060731:Emergency Responders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications / Q000706:statistics & numerical data*; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D012042:Registries; D013689:Telephone; D060145:Text Messaging / Q000706:statistics & numerical data*; D013997:Time Factors; D061665:Time-to-Treatment / Q000706:statistics & numerical data*
keywords: First responder; Out of hospital cardiac arrest; Recruitment system; Survival