The First Responder Shock Trial (FIRST)

Dr Ziad Nehme, Monash University

2022 Vanguard Grant

Years funded: 2023-2024

Out-of-hospital cardiac arrest (OHCA) is the ultimate prehospital emergency. For every minute that passes without cardiopulmonary resuscitation (CPR), the likelihood of survival decreases by approximately 10%. Timely action by bystanders is critical for survival. Early defibrillation by bystanders using an automated external defibrillator (AED) halves the time to first defibrillation and produces survival rates above 50%. Unfortunately, only 2% of OHCA are currently receiving bystander defibrillation. This randomised controlled trial (RCT) will examine the benefit and cost-effectiveness of a new strategy of AED deployment, combining a smartphone application and an ultraportable AED to maximise the early potential for defibrillation by bystanders. The trial will be conducted in Victoria and New Zealand and aims to determine whether the novel strategy can improve OHCA survival rates. The trial addresses the socioeconomic and geographical barriers impeding community use of AEDs and has the potential to significantly improve patient outcomes.