Community first responders: improving access to defibrillation in cardiac arrest

There are approximately 60 000 out-of-hospital cardiac arrests in the UK each year (Ambulance Service Association, 2006) with survival rates of between 6% and 16% declared by the ambulance service NHS Trusts in the latest survival statistics (NHS England, 2015).

Evidence suggests survival rates could be improved with earlier identification and access to care for victims of out-of-hospital cardiac arrest. In 1988 Mary M. Newman of the Sudden Cardiac Arrest Foundation first described the ‘Chain of Survival,’ four interlinked interventions required to improve outcomes in out-of-hospital cardiac arrest. The chain relies on early identification, early cardio pulmonary resuscitation (CPR), early defibrillation and early advanced care (see Figure 1). This chain has been widely acknowledged and adopted by the bodies promoting resuscitation since that time and was incorporated into the International Liaison Committee on Resuscitation (ILCOR) guidance in 1997.