Follow-up Program for First Aid Providers

This project is a follow-up program for individuals who have been present or performed first aid for an unconscious person. 
The offer is given to first aid providers from all over Norway.


This is a subproject of the national campaign «Saving lives together».

The Importance of First Aid

Every year more than 3500 people experience sudden out-of-hospital cardiac arrest in Norway. One of t​he most important factors for survival consist of bystanders calling emergency medical dispatch number 113 as well as initiating cardiopulmonary resuscitation (CPR). Bystander CPR can increase the probability of survival by a threefold. Since the 1960s society have provided the public with extensive first aid training and strongly encouraged everyone to provide first aid.

Saving lives together

In 2017, "Saving lives together", on the initiative of the Ministry of Health and Care Services, was introduced as a national campaign to increase society's preparedness for cardiac arrest and other time-critical conditions, with a special focus on the public as a prehospital resource. One of the main tasks of this campaign is implementing extensive and widespread first aid training.
The Follow-up program for first aid providers is run by RAKOS and is a sub-project in the national charity event "Saving lives together".
RAKOS also collaborates with the Norwegian Directorate of Health on this program.

 

Ambulance workers provide first aid to person on the ground. Woman stands alone

Ambulance workers provide Advanced Cardiovascular Life Support (ACLS). First aid provider stand alone. Foto: Svein Lunde, SUS.

A tough experience

Preforming CPR can be a tough experience, especially for lay rescuers with no medical background. Such an incidence can lead to persistent adverse effects. Many struggle with guilt for providing insufficient CPR. In addition, many worry about the patient's outcome. First aid providers have no possibility of obtaining such information, except for those who are Next of  Kin. First aid providers can experience flashbacks, sleeping disorders, weight loss, anxiety, concentration difficulties, reduced work capacity etc. These results were presented in a study conducted by Mathiesen and Bjørshol et al. at Stavanger University Hospital. Until now, there has been nowhere for first aid providers to turn for help to process their traumatic experience.

Training in first aid is not sufficient to prepare people for the psychological strain they will undertake both during and after taking part in a first aid situation. Medical personnel often conduct a debrief after severe incidents. However, first aid providers are seldom included, though it may have been their efforts which had the greatest impact on the patient's outcome The purpose of this follow-up program is to help the first aid providers to process a difficult experience and to review the incident together with professionals. Simultaneously, we wish to help them attain a sense of achievement despite the personal strain following the experience.

Target group

Follow-up is offered to people who have been present or provided first aid to an unconscious person. The offer includes lay people, health personnel who perform first aid outside working hours and emergency workers. The offer applies to first aiders from all over Norway.

This program will consist of the following components:

1. A consultation with experienced health care professionals
Equivalent to a debriefing, in which health care professionals participate regularly.  No information concerning the specific incidence or specific patient will be revealed. The exception is if we obtain consent to pass on the patient's outcome. Medical and technical questions from the first aid provider will be answered on a general basis.

2. Information regarding patient outcome
Many first aid providers who are not Next of Kin wish to know the patient's outcome, also if the patient might have died. It is important that the first aid provider is not left with guilt after a negative outcome (only 1 out of 6 cardiac arrest pasients survive). For health care professionals there is an opening in the legislation which provides them with the opportunity to obtain information concerning a patient's outcome in cases were they have provided treatment. It is reasonable that lay rescuers and volunteer first responders who provide life-saving first aid, should receive at least some of this information. ​If the first aider wants to know the patient's outcome, we therefore ask for consent from the patient or the patient's relatives. If we get consent, the first aider can find out if the patient survived or not. No other information ​​about the patient, such as diagnoses or identity, is provided.

 3. Information about contagious diseases and testing
First aid providers are rarely exposed to infectious diseases.  However, the risk of contracting a contagious disease may cause great concern for some. If the first aid provider addresses the topic or if we believe there is a reasonable chance they may have contracted a disease, this will be handled. If necessary, we will advise the first aid provider to contact their general physician for a consultation and possible testing.

4. Feedback to the health care system
It is important to obtain feedback from the first aid providers. Both information about their experience of providing first aid and their experience with the emergency medical services may be of great use​. All relevant feedback will be conveyed in order to improve the emergency medical services.

Further Follow-up

Most first aid providers will not be in need of further follow-up than what is portrayed in this project. However, if some should in fact show symptoms of psychological disorders due to the first aid incidents (such as anxiety, depression, suicidal thoughts etc.) they will be referred to the ordinary health care system for diagnosis and treatment.  

Collaboration with ​​​other health trusts

Although RAKOS already today offer follow-up to first aiders from all over the country, the goal is for first aiders to be offered follow-up from their local health trust. In this context, we have started a collaboration with Sykehuset Innlandet, which will provide a local follow-up offer during the autumn of 2021. We are also collaborating with Helse Fonna, which advertises our follow-up offer through its ambulance service and AMK.
We hope to create more good collaborations in the future.


​​​Research

​By consent, data is collected for research from first aiders who take part in the program. The research will try to map the first aider's reactions over time, as well as map the needs for such a program and what effect it has on first aiders who have taken part in the program.


Contact

Please call us on phone number: 02415.

The offer is free and we have a duty of confidentiality.

Please contact Anna Moe Øvstebø in case of questions.
E-mail: anna.marie.moe.ovstebo@sus.no​

In case of emergency call 113

If it's a little urgent, call the emergency room 116117

More information

For more information about the Follow up program see: Førstehjelpere - Helse Stavanger (helse-stavanger.no)

​ Videopresentations of the project:

Oppfølging av førstehjelpere – kort presentasjon (7min)

Oppfølging av førstehjelpere – lengre presentasjon (15 min)

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