Evidence map›Paper›PMID 42104269›Full record

ReviewInternational journal of emergency medicine2026

Barriers and facilitators while implementing community first responder systems in a western setting: mixed-methods expert consensus.

E Moens, E Degraeuwe, M L Caputo, R Cresta, R Greif, E Baldi, T Barry, B W Böttiger, J Bray, H J Busch and 35 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in International journal of emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

45 authors.

E Moens *Ghent University Hospital, Ghent, Belgium.
E Degraeuwe *Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.
M L CaputoDepartment of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland.
R CrestaFondazione Ticino Cuore, Lugano, Switzerland.
R GreifFaculty of Medicine, University of Bern, Bern, Switzerland.
E BaldiDivision of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
T BarrySchool of Population Health, Royal College of Surgeons in Ireland, Dublin, Ireland.
B W BöttigerDepartment of Anaesthesiology and Intensive Care Medicine, Medical Faculty and University Hospital of Cologne, Cologne, Germany.
J BrayMonash School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
H J BuschDepartment of Emergency Medicine, University Medical Center Freiburg, Faculty of Medicine, Freiburg, Germany.
S CheskesDepartment of Family and Community Medicine, Division of Emergency Medicine, University of Toronto, Toronto, Canada.
C D DeakinSouth Central Ambulance Service NHS Foundation Trust, Southampton, UK.
A A DoshiUniversity of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
M M EkkelAnesthesiology, Amsterdam UMC, Amsterdam, The Netherlands.
D ElschenbroichCharité - Universitäts medizin Berlin, Berlin, Germany.
D FredmanHeartrunner Citizen Responder System, Heartrunner Sweden AB, Solna, Sweden.
L GamberiniUnit of Anaesthesia and Emergency, Maggiore Hospital, Bologna, Italy.
J GanterDepartment of Anaesthesiology and Critical Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany.
F L HenriksenDepartment of Cardiology, Odense University Hospital, Odense, Denmark.
C J JagtenbergDepartment of Operations Analytics, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
M JonssonCenter for Resuscitation Science, Karolinska Institutet, Stockholm, Sweden.
M KhalemskyInformation Systems Management Studies, Jerusalem Multidisciplinary College, Jerusalem, Israel.
T MarksDepartment of Anaesthesiology, University Medicine Greifswald, Greifswald, Germany.
B MetelmannDepartment of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Medicine Greifswald, Greifswald, Germany.
C MetelmannDepartment of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Medicine Greifswald, Greifswald, Germany.
K G MonsieursEmergency Department, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium.
M P MüllerDepartment of Anaesthesiology, Intensive Care, and Emergency Medicine, St. Josefs Hospital Freiburg, Freiburg, Germany.
W MingDepartment of Emergency Medicine, Ng Teng Fong General Hospital, Singapore, Singapore.
J S PoothDepartment of Emergency Medicine, University Medical Center Freiburg, Freiburg, Germany.
S PrasseItalian Resuscitation Council, Rome, Italy.
D D SalcidoUniversity of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
A ScapigliatiInstitute of Anaesthesia and Intensive Care, Catholic University of the Sacred Heart, Rome, Italy.
N SchittkoADAC Stiftung, München, Germany.
S SchnaubeltEmergency Medical Service Vienna, Vienna, Austria.
S S ScholzDepartment of Anaesthesiology, Intensive Care, Emergency Medicine, Bielefeld University, Bielefeld, Germany.
T ScquizzatoDepartment of Anesthesia and Intensive Care, San Raffaele Scientific Institute, Milan, Italy.
P ShahriariEmergency Medical Services, Capital Region of Denmark, Copenhagen, Denmark.
P SnobelenPeel Regional Paramedic Services, Brampton, ON, Canada.
R StieglisAnesthesiology, Amsterdam UMC, Amsterdam, The Netherlands.
B StrickmannOffice for Civil Protection and EMS, Gütersloh, Germany.
H L TanDepartment of Experimental Cardiology, Amsterdam UMC, Amsterdam, The Netherlands.
K C ThiesDepartment of Anaesthesiology, University Hospital of Bielefeld, Bielefeld, Germany.
G TrummerDepartment of Emergency Medicine, University Medical Center Freiburg, Freiburg, Germany.
W A WetschDepartment of Anaesthesiology and Intensive Care Medicine, Medical Faculty and University Hospital of Cologne, Cologne, Germany.
S VercammenEVapp NGO, Ghent, Belgium. steven.vercammen@evapp.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly cardiopulmonary resuscitation and timely defibrillation are key determinants of out-of-hospital cardiac arrest survival. Community first responder (CFR) networks improve early response, yet adoption varies internationally. This study summarizes current key factors affecting CFR-system implementation through an international expert consensus process.

methodsA mixed-methods design explored barriers and facilitators to CFR system development. Data were collected during an expert consensus workshop in April 2024 Hinterzarten, Germany (46 experts, 14 countries) and an online survey. Experts were invited based on previous authorship regarding CFR systems. Thematic content analysis and descriptive statistics identified recurrent themes and areas of agreement.

resultsExperts agreed on core needs for effective CFR systems with high consensus regarding locally adapted dispatch algorithms, clear privacy rules for CFR activation, sufficient CFR training, structured debriefing and psychological support. Congruence was weaker regarding funding, legal or governance frameworks, reflecting variation in responsibilities, liability, and automated external defibrillator- (AED-) registry organisation. Findings were structured around a previously developed roadmap outlining four stages of CFR-system maturation. In the exploration phase, unrecognition of delays in Basic Life Support initiation impedes translation of practice gaps into action. Installation is challenged by recruitment, funding, and coordination among stakeholders. Implementation requires outcome evaluation. Moreover, sustainability is threatened by volunteer attrition and reliance on government budgets. Supportive legal frameworks, centralised AED registries, and integration into national health initiatives facilitate both establishment and long-term stability.

conclusionThis exploratory expert consensus process on CFR system implementation highlights the need for stable funding, coherent governance, aligned legal frameworks, comprehensive and exhaustive AED registration, data-driven feedback from practice to system optimisation and targeted training of CFR.

Indexed as

AEDBasic life supportCommunity first responderSmartphone alerting system

Identifiers

PMID42104269
PMCPMC13251221

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.