Professional firefighter and trained volunteer first-responding units in emergency medical service

Abstract

BACKGROUND: Although widely dispatched to out-of-hospital cardiac arrests, the performance of prehospital first-responding units in other medical emergencies is unknown. METHODS: In this retrospective, descriptive study, the general performance of 44 first-responding units in Pirkanmaa County, Finland, were examined. A subgroup analysis compared the first-responding units made up of professional firefighters and trained volunteers. RESULTS: First-responding units were dispatched to patients during 1622 missions between 1 January 2013 and 31 December 2013. The median time to reach the scene was 9 minutes in any mission. Overall, first responders evaluated 1015 patients and provided treatment or assisted ambulance personnel in 793 (78%) cases. The most common treatment modalities were assistance, such as carrying (22%) and the administration of supplemental oxygen (19%). There were 83 resuscitation attempts during the time period. In 42 of these, first-responding units initiated basic life support a median of 4 minutes prior to the arrival of ambulance personnel. Return of spontaneous circulation was achieved in 20% of cases. The subgroup analysis showed that trained volunteers administered oxygen more liberally than professional firefighters in stroke and chest pain mission (stroke: professional 9/236 cases [4%] vs layperson 26/181 cases [14%], P < 0.001; chest pain: professional 16/78 cases [21%] vs layperson 77/159 cases [48%], P < 0.001). CONCLUSION: First-responding units provided initial treatment or assistance to ambulance personnel in approximately half of the missions. Implementation of professional- and layperson-staffed first-responding units in emergency medical service system seems to be feasible.