What to expect from a smartphone dispatch application for out-of-hospital cardiac arrest in a national population?

Abstract

Introduction: Smartphone applications to dispatch citizen responders for out-of-hospital cardiac arrest (OHCA) aim to improve survival rates by reducing response times. Since 2018, the SAUV Life application was deployed across France and made available to all citizens.

Methods: We conducted a national observational study using data collected prospectively from the application between January 2018, and November 2022. In OHCA cases (incidents), citizen responders were dispatched (interventions) by emergency medical services (EMS), guided through the application to perform cardiopulmonary resuscitation (CPR) and use public automated external defibrillators (AED). Users were categorized as trained or untrained in first aid. The primary outcome was arrival before EMS.

Results: During the study period, the application progressively covered 78% of the French population, with 594,404 registered users. The application triggered 1,078,082 smartphone alerts, leading to 30,186 user interventions in response to 24,159 OHCA incidents. In 3,690/24,159 (15%) incidents where users arrived before EMS, chest compressions were initiated in 2,585/3,690 (70%) of cases and AED brought in 116/3,690 (3%) of cases. In multivariable analysis, being a trained user was associated with arrival before EMS (OR 2.58; 95% CI, 2.25-2.95; P < 0.01), as were age < 38 years (OR 1.17; 95% CI, 1.10-1.25; P < 0.01), shorter distance to the incident (OR 0.98; 95% CI, 0.97-0.99; P < 0.01), and more years of application use (OR 1.06; 95% CI, 1.03-1.09; P < 0.01).

Conclusion: The nationwide deployment of a smartphone dispatch application facilitated citizen response and CPR initiation before EMS arrival, highlighting the importance of continuously expanding the citizen responder network to improve OHCA outcomes.

Keywords: Application; Citizen responders; First aid; Out-of-hospital cardiac arrest; Smartphone.