Motivation, challenges and realities of volunteer community cardiac arrest response: a qualitative study of ‘lay’ community first responders

ObjectivesTo explore the reasons why lay community first responders (CFRs) volunteer to participate in out-of-hospital cardiac arrest response and the realities of their experience in providing this service to the community.DesignA qualitative study, using in-depth semistructured interviews that were recorded and transcribed. Thematic analysis was undertaken and credibility checks conducted.SettingNine geographically varied lay CFR schemes throughout Ireland.ParticipantsTwelve experienced CFRs.ResultsCFRs were motivated to participate based on a variety of factors. These included altruistic, social and pre-existing emergency care interest. A proportion of CFRs may volunteer because of experience of cardiac arrest or illness in a relative. Sophisticated structures and complex care appear to underpin CFR involvement in out-of-hospital cardiac arrest. Strategic and organisational issues, multifaceted cardiac arrest care and the psychosocial impact of participation were considered.ConclusionsHealth systems that facilitate CFR out-of-hospital cardiac arrest response should consider a variety of relevant issues. These issues include the suitability of those that volunteer, complexities of resuscitation/end-of-life care, responder psychological welfare as well as CFRs’ core role of providing early basic life support and defibrillation in the community.