Public access defibrillation: psychological consequences in responders

Adverse psychological reactions are relatively frequent in professional ambulance crews who attend traumatic events, yet appear unusual in lay persons who attempt resuscitation of victims of out of hospital cardiac arrest.

To investigate the psychological profile of first responders to gain insight into possible factors that might protect them against such reactions.

Qualitative study of first responders in a community scheme in Barry, South Wales. In depth semi-structured interviews with six subjects were analysed using Interpretive Phenomenological Analysis (IPA).

The study identified a resilience phenomenon in first responders accounted for by certain enabling core beliefs about their role, their capacity, and about the meaning of negative and positive outcomes for themselves. A realistic appreciation of their own limitations, confidence in their ability to perform as trained and being able to handle positive and negative outcomes were prominent features. The ability to act with emotional detachment appears a further protective mechanism. This mindset, loosely described as 'a philosophy', protects against the development of adverse reactions to stress or from becoming unduly concerned about negative outcomes. The responders had altruistic motives for undertaking the role yet were capable of operating with a high degree of naturally occurring resilience to stress or undermining anxiety. It is the combination of being motivated by altruism coupled with an inherent resilience that appears to be the crucial protective mechanism.

The group demonstrated an apparently innate resilience to the adverse psychological effects of responding with an AED in a PAD scheme. This enables them to operate optimally in stressful situations without experiencing the negative psychological consequences that might otherwise arise. This information may be used to raise awareness about the psychological requirements for the role and to assist screening or selection processes.