Abstract

Background: To improve out-of-hospital cardiac arrest (OHCA) survival rates in Japan, implementation of a community first responder (CFR) system is considered one of the most effective emergency medical service options. We investigated the possibility of introducing a CFR system in Japan.

Methods: Cross-sectional surveys were given to 1,350 residents over the age of 18 who were selected from resident registration lists in Tochigi prefecture. Residents were questioned whether they would agree to have a CFR system in their community and whether they would participate as a responder. Positive attitudes about the cross-sectional study led us to conduct pilot CFR trials. Trials were conducted in rural areas of Tochigi prefecture by local EMS personnel. We were able to discuss and develop CFR introduction guidelines for Japanese communities using the results of the individual surveys, pilot trials, and other countries’ guidelines. Finally, our CFR system, which referred to developed CFR introduction guidelines, was introduced into Ishikawa prefecture’s Shioya town (population of 710).

Results: A total of 92.5% of Tochigi residents either strongly agreed or agreed to have a CFR system in their community, and 16.7% of Tochigi’s residents chose to participate. The two CFR introduction prerequisites were identified as: (1) an information delivery system for CFR and (2) budget preparation. CFR introduction guidelines were developed, and a CFR system was introduced in Shioya town on 4 November 2012 with 32 participants. On 1 January 2013, a CFR responded for the first time, and the CFR system worked efficiently.

Conclusions: By providing information about the CFR system to the community and preparing several infrastructural elements, it was possible to introduce and operate a successful CFR system in Japan.

Keywords: Out-of-hospital cardiac arrest (OHCA); Community first responder (CFR); Emergency medical service (EMS); Japan