Activation of community first responders to pediatric out-of-hospital cardiac arrests in Denmark.

BACKGROUND: Activation of community first responders (CFRs) to adult out-of-hospital cardiac arrests (OHCAs) increases bystander cardiopulmonary resuscitation (CPR). In Denmark, national guidelines were expanded to include pediatric OHCAs (ages 0-17), highlighting the need to explore both CFR involvement and potential psychological impact.

OBJECTIVES: To examine the involvement of CFRs in pediatric OHCAs in Denmark, including the interventions performed, self-reported immediate distress, and the need for follow-up care.

METHODS: We analyzed pediatric OHCAs with CFR activation from the Danish Cardiac Arrest Registry and the CFR mission database between September 2017 and December 2023. Data included patient characteristics and CFR questionnaire responses regarding interventions, immediate distress, and follow-up needs. Analyses were descriptive and exploratory.

RESULTS: In 55 pediatric OHCAs, 794 CFRs were activated. Of these, 157 arrived at the scene; 85/157 (54%) arrived before EMS, 47/157 (30%) performed CPR, and 44/157 (28%) provided support to relatives. Moderate or severe self-reported immediate distress was reported by 53/157 (34%), more common among those who arrived before EMS (44/85, 52%), performed CPR (30/47, 64%), or in cases of children <4 years (35/77, 45%). Most CFRs (155/157, 99%) remained willing to continue volunteering afterwards.

CONCLUSION: CFR activation to pediatric OHCAs was associated with early resuscitative efforts. One-third reported moderate or severe immediate distress, particularly when arriving before EMS, performing CPR, or responding to younger children. The majority of the CFRs remained willing to remain in the system afterwards. Findings reflect immediate responses and should be interpreted alongside the potential benefits of early interventions.