Influence of bystander activation on pre-hospital emergency care response time: systematic review

Abstract

This article presents a systematic review and analysis of grey literature to identify and address gaps in knowledge regarding the

role and influence of bystander activation on pre-hospital emer- gency care (PEC) response time. We conducted a systematic search

for full-text articles published since 2000 in Web of Science,

PubMed, Science Direct, and Google Scholar databases. We fol- lowed the Preferred Reporting Items for Systematic Reviews and

Meta-Analyses (PRISMA) guidelines, using “pre-hospital emer- gency care response time” and “bystanders” as search keywords.

The risk of bias was assessed using the ROBINS-I tool. Our analy- sis included forty-six relevant studies meeting the inclusion crite- ria. However, we observed that many studies were poorly reported,

posing risks of selection and detection biases. Additionally, we identified methodological and study design weaknesses in five studies. Given the critical role of PEC services in saving lives and preventing medical complications, the timely provision of these services is paramount. Bystanders play a central role in activating

emergency medical services (EMS) and providing cardiopul- monary resuscitation. Prompt calls to EMS by bystanders resulted

in reduced PEC response times, improved survival chances, and better neurological outcomes, particularly among out-of-hospital cardiac arrest patients. There is substantial evidence that prompt bystander activation of EMS significantly reduces PEC response

times, thereby saving lives and strengthening existing PEC sys- tems. However, further research is necessary to accurately assess

the impact of different interventions aimed at enhancing bystander activation of EMS and reducing PEC response times.