Steven Brooks: The Neighbours Saving Neighbours Study: Feasibility of a community volunteer resuscitation team integrated with local EMS for victims of out-of-hospital cardiac arrest

Out-of-hospital cardiac arrest is a significant public health problem. Every year

there are approximately 40,000 OHCA annually in Canada with only 8-12%

surviving to hospital discharge. Early cardiopulmonary resuscitation (CPR) and

defibrillation have been highlighted as key links in the “Chain of Survival” for

patients who suffer OHCA. Treatment for cardiac arrest is very time-sensitive;

the probability of survival decreases by approximately 10% for every minute that

CPR and defibrillation are not provided. In many Canadian communities,

especially those outside of dense urban settings, getting paramedics to the

scene quickly is difficult. In many cases, paramedics may be require more than

15-20 minutes from the 9-1-1 call to arrive on scene. As such, CPR and AED

use delivered by witnesses on the scene is of paramount importance but

happens in the minority of cases.


In countries outside of Canada, many EMS systems have developed community

responder programs to address this challenge. These programs involve offduty

health care professionals and lay people to respond in parallel with

professional EMS. These volunteer responders from the community receive

training, equipment and communications devices to facilitate this new tier of

response to 9-1-1 emergencies. This model is not well-established in Canada

and has never been rigorously tested. There are no community first responder

programs specifically targeting cardiac arrest in Canada.


In a partnership with resuscitation scientists from several Canadian universities,

the University of Edinburgh, and 2 local Paramedic services, we propose a

study to establish the feasibility of a cardiac arrest community responder

program in Canada. This is the first step in a planned research agenda to

determine effectiveness of community volunteer responders for cardiac arrest.

Data from this preliminary feasibility study will support the development of a

definitive clinical trial within the Canadian Resuscitation Outcomes Consortium



The project objectives are 1) to assess the feasibility of a community volunteer

cardiac arrest response program to provide rapid, high-quality basic life support

for victims of OHCA in Frontenac, Hastings and Prince Edward counties of

Southern Ontario, and 2) to assess the acceptability of the community volunteer

cardiac arrest responder program among key witnesses to OHCA (e.g. 9-1-1

callers, family members) and paramedics involved in emergency response

situations attended by community volunteer cardiac arrest responders.


We will implement volunteer teams in 40 targeted townships across Frontenac,

Hastings and Prince Edward Counties in Southeastern Ontario. Townships

outside of dense urban areas with a history of longer EMS response times will

be prioritized. Four to eight volunteers for each team will receive training in

basic life support, an AED and a dispatch communications device. The local 9-

1-1 service will dispatch the on-call team member when they are closer to the

cardiac arrest than the nearest EMS unit. Volunteers will be trained to provide

CPR and use the AED while professional crews are on their way. We will

measure the feasibility of volunteer recruitment, retention and training. Program

administrative data, clinical data, CPR quality data from the AED and clinical

outcomes will be used to satisfy objective 1. Semi-structured interviews with

witnesses, family members and responding paramedics will be used to

determine the acceptability of this new mode of responding to cardiac arrest

emergencies in the community.

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