Reasons why smartphone-alerted first responders abort missions: Findings from a sequential mixed-methods study

Area of Science:

• Emergency Medicine
• Public Health
• Health Informatics

Background:

• Smartphone-based first responder systems aim to decrease treatment times for out-of-hospital cardiac arrests (OHCA).
• A significant percentage of alerted first responders discontinue missions after accepting alerts, hindering system efficiency.
• Understanding reasons for mission abandonment is crucial for enhancing the prehospital chain of survival.

Purpose of the Study:

• To identify and categorize reasons why smartphone-alerted first responders abort missions.
• To quantify the frequency of these reasons through a large-scale survey.

Main Methods:

• A mixed-methods approach was employed, starting with semi-structured interviews with first responders in Munich.
• Qualitative content analysis of interviews informed the development of a quantitative online survey.
• Survey data from 334 first responders using the Mobile Retter app were analyzed.

Main Results:

• 38.9% of responders reported mission abandonment after acceptance.
• The primary reasons for abandonment were lack of time advantage over emergency medical services (41.8%), excessive estimated distance (21.6%), and difficulty locating the emergency site (12.2%).
• Other factors included perceived medically unnecessary alarms and situational unavailability.

Conclusions:

• Mission abandonment is more frequently linked to structural and informational issues than safety concerns.
• Optimizing dispatch information, improving location accuracy, and refining alert criteria can reduce mission discontinuations.
• Enhancements are vital for strengthening the effectiveness of smartphone-alerted first responder systems in urban settings.