Out-of-hospital cardiac arrest management in the Swiss canton of Valais: a retrospective study on first responders' response and automated external defibrillator efficacy.

STUDY AIMS: Cardiac arrest is a condition with a high mortality rate, with most cases occurring outside hospital. First responders (defined as public responders in our study) play an increasingly important role in management through the early initiation of cardiopulmonary resuscitation and defibrillation. Several studies have shown that the involvement of public responders can result in faster initiation of resuscitation and increased survival. This study evaluated the management of out-of-hospital cardiac arrest by public responders and the effectiveness of the FRED-PA1 automated external defibrillator (AED) available in the canton of Valais, Switzerland. METHODS: This was a retrospective study including consecutive cases of out-of-hospital cardiac arrest occurring between January 2021 and December 2023 in the canton of Valais. Response times of public responders and emergency medical services (EMS) were evaluated, along with initial rhythms, survival, and the performance and safety of the available AEDs. RESULTS: A total of 107 patients were included in the study. In 68% of cases, a public responder arrived at the scene first, with a significantly shorter interval between emergency call and on-site arrival compared with EMSs (p = 0.019). Ventricular fibrillation was more frequent in the EMS group than the public responders group (35 vs 23%) (non-significant [NS]). Survival on arrival at hospital was 19% in the public responder group and 24% in the EMS group (NS). Survival to hospital discharge was 9.6% in the public responder group and 15% in the EMS group (NS). Concerning the AEDs, the rhythm recognition algorithm was deemed to be effective and consistent with current recommendations. CONCLUSION: This retrospective study demonstrates the key role played by public responders, who are frequently the first to arrive at the scene of out-of-hospital cardiac arrests. The FRED-PA1 AED algorithm meets the standards in the literature. However, ongoing prospective studies will highlight and optimise the role of public responders in out-of-hospital cardiac arrests.