It is a stark reality for people living in rural parts of Ireland that services are simply not as efficient as for our urban counterparts. This can have a serious impact. For someone suffering chest pains, cardiac arrest or a stroke it may well be too late by the time an ambulance arrives.

For this reason, the Community First Responder (CFR) scheme may be one of the most important initiatives in rural Ireland. A CFR Scheme is an organisation of people from a community who are trained in CPR, with the idea that these trained locals will respond to emergencies – involving chest pain, cardiac arrest or stroke – before the ambulance arrives.

The first responders are linked with the National Ambulance Service, working together to keep patients alive until the ambulance can attend.

The operational function of the scheme is effective, given the rurality that it operates in. When an emergency call is received by an ambulance for a suspected heart attack/stroke, a text message is sent to trained first responders in that area. They then attend the scene and perform CPR, often before the ambulance arrives.

Lightfoot ambulanc Report

A report published by Lightfoot Solutions last October on the nationwide ambulance service doesn’t just give an overview of our rural ambulance service, but a definite indication that a first responder scheme is paramount in rural Ireland for problems such as cardiac arrests and strokes.

The report, conducted by an Independent British consultancy, found that in rural Ireland, just 6.6% of ambulances reach the caller in less than eight minutes and only 44% of ambulances reach their caller in less than 19 minutes.

According to the Irish Heart Foundation, a person’s chance of survival decreases by 10% for every minute without CPR or defibrillation. For these reasons, the figures produced by the Lightfoot report last year are concerning.

What is equally as concerning is just how far off the targets these responses are. While eight-minute response times have a HIQA target of 80%, less than 19 minute responses have a HIQA target of 95%.

Listen to a discussion of the First Responder's work in our podcast below:

Rather than criticise the ambulance service in Ireland, however, one must be realistic. According to the report, 40% of ambulance call-outs are in rural areas and the time of response depends largely on the location of the ambulance. As stated in the report, the “immense difficulties with rurality in Ireland” means that the “NAS cannot possibly achieve the HIQA-prescribed target of 80% in eight minutes”.

In addition, the report concludes that even additional resources will not fully fix this problem.

This is why the First Responder scheme is so vital. A comprehensive service delivered by a Community First Responder Scheme nationwide could fill these gaps. A close-by first responder reacting quickly to perform CPR on the patient before the ambulance arrives could be the difference between life and death.

Irish Heart Foundation advice

Following a cardiac arrest minutes matter. We need people to recognise early that the person needs CPR. By having a CFR group in a community they will be dispatched immediately when the emergency call comes in. The earlier responders arrive with an AED (automated external defibrillator) the better the victim’s chances of survival.

There are five links in the chain of survival, the first three links can be completed by responders. If these three links are intact, the victim’s chances of survival are much improved.

For survival we need: