By Florentine Dame
dpa
ESSEN, Germany 鈥� Time is critical when someone鈥檚 heart stops beating - and resuscitation is key.
Bystanders action can be crucial for survival but what if there is no one nearby who knows how?
Capacities vary widely across Europe.
| More: How to measure high-quality CPR
Many countries are trying to increase lay resuscitation rates, teaching people cardiopulmonary resuscitation (CPR) skills who are not health-care professionals such as bystanders or first responders.
The aim is to have 鈥渘ations of life-savers, communities with the readiness to respond to cardiac arrest. This is the vision of the future,鈥� says the European Resuscitation Council (ERC), a non-profit promoting the issue across Europe.
It is calling for training, education, guidelines and 鈥渕otivated people ready to change hearts and minds.鈥�
But while some Scandinavian nations have rates greater than 80%, Germany鈥檚 is around 40% and even lower in Britain.
The Resuscitation Council UK is working towards a day when every person in society has the skills they need to save a life, 鈥渄riving CPR education, and encouraging everyone, from healthcare workers to the general public, to learn life-saving resuscitation skills.鈥�
Faster response = better outcomes
The aim is for more people to reach hospital with their best chance of surviving a cardiac arrest, 鈥渁nd with an opportunity to receive the care they deserve both during the event and while they recover.鈥�
The urgency of the issue is familiar to volunteer firefighters who attended training recently in Essen, Germany.
All were paying close attention this evening at the fire station as they learned how to become potential lifesavers with first aid knowledge, smartphones and a bit of luck.
They are part of a mobile rescue initiative, which involves an app to notify those who are trained nearby if an emergency arises.
Technology can help
When someone notifies the emergency services that a person has had a heart attack, the volunteers will also be alerted through an app, in case they happen to be near where the situation is unfolding.
The firemen sitting in the station are part of a growing network though officials say this must become far denser.
Launched in 2013 as the first first responder alert system of its kind in Germany, the Mobile Retter app - meaning mobile rescuer - links 22,500 participants in almost 40 cities and districts in six federal states.
The math is simple. More than 120,000 people nationwide suffer sudden cardiac arrest outside of a hospital every year, according to the German Resuscitation Council.
Only one in 10 survives 鈥� partly because it takes the emergency services an average of 9 minutes to arrive on the scene.
Much of Europe playing catch up
First responder apps 鈥� long established in Scandinavia and the Netherlands 鈥� can be crucial, say specialists from the Bj枚rn Steiger Foundation in a position paper.
鈥淭he brain starts to die after 3 minutes. We have to fill this gap,鈥� says Fire Chief Jan Kuhlmann, who is responsible for mobile rescuer training at the Essen fire brigade.
Essen is one of the first major cities to adopt the mobile rescuer principle, established some years ago.
In rural areas, long distances make it difficult to provide rapid assistance, while in cities, heavy traffic makes it even more challenging 鈥� which makes the system all the more valuable, says Kuhlmann.
Essen鈥檚 community of registered first responders include firefighters, nurses, paramedics and doctors. 鈥淎 first aid course for a driving licence is not enough,鈥� says Kuhlmann. 鈥淭he control centre must be sure that the person they send out is capable of doing the job.鈥�
The training therefore focuses not on resuscitation techniques, but on technical procedures 鈥� and success: since its introduction in 2019, the more than 1,000 helpers in Essen have been called out around 1,900 times, responding to almost 550 of those calls 鈥� and arriving at the scene within three and a half minutes on average, often before the emergency services.
The life-saving idea for the app came from East Westphalian emergency physician Ralf Stroop when he saw the blue lights of an ambulance in his neighbourhood.
He realized that he could have helped earlier 鈥� if only he had known about the emergency in time. That was the initial spark.
Common standards needed
A number of imitators have long since established themselves: According to the Bj枚rn Steiger Foundation, at least six different systems are used in Germany, and vary from one state to the next.
鈥淪o far, these are all isolated solutions 鈥� with different standards in the details and without cross-technology alert options,鈥� says Mobile-Retter managing director Stefan Prasse. 鈥淏ut we are all united by the goal of saving lives.鈥�
Efforts are under way to reach common standards. 鈥淭his doesn鈥檛 mean that everyone has to use the same system, but the systems must be compatible with each other.鈥�
However, technology alone is not enough. 鈥淚f nothing happens for months after registration, there is an increased risk that participants will delete the app. Active volunteer management can help prevent this,鈥� says Prasse.
He says anything related to the project to motivate volunteers is conceivable, from joint activities to networking via social media and sharing success stories.
Emergency medics support the rescuer approach and would like to see it established nationwide and enshrined in law. 鈥淭hese apps are currently the most effective means of improving the chances of survival in cases of cardiac arrest,鈥� says Clemens Kill , head of the Centre for Emergency Medicine in Essen and chairman of the German Society for Rescue Services and Preclinical Emergency Medicine (DGRN).
鈥淚deally, every citizen would know what to do 鈥� and actually do it,鈥� he says.
But Germany鈥檚 lay resuscitation rate still lags behind that of other countries such as Sweden and the Netherlands , despite numerous efforts to intensify training in schools.
鈥淚t is of course difficult to teach people something they will probably only need decades later,鈥� says Kill. The approach of having emergency call centre staff guide callers through CPR over the phone is not practised reliably at all call centres, he adds. 鈥淲e need to involve the entire emergency services in such first responder systems. Police officers and firefighters also know how to perform CPR.鈥�
Whether an emergency call centre works with an app should also no longer be left to the random commitment of individuals. 鈥淚t cannot be that when it comes to life and death, the state simply hopes that people will get together and do something,鈥� he says. 鈥淭his must be included in the legal framework for emergency services.鈥�
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