Vem har och tar ansvar! : – I Väntan På Ambulans (IVPA)-uppdrag i Glesbygdsmiljö

Sammanfattning: Aim: The overall aim was to explore and describe experiences from the perspective of different actors in While Waiting for Ambulance (WWFA) assignments in a rural environment. The four studies aimed: to describe WWFA and ambulance assignments in rural environments, focusing on frequency, event time and actions of firefighters before an ambulance arrives at the scene, and to evaluate these actions (I); to describe emergency situations involving  WWFA assignment in a rural environment from the caller´s perspective (II); to describe compliance with the telephone-assisted cardiopulmonary resuscitation (T-CPR) protocol, the performance of the laypersons in a simulated T-CPR situation, and the communication between laypersons and EMDs during these actions (III); to describe WWFA assignment in a rural environment from the firefighters’ and the ambulance staff’s perspective (IV).Methods: The studies had a descriptive and comparative design. They were analysed with a qualitative and quantitative methods.Results: In event time showed the process time between ambulance staff and firefighters as significantly statistically different, to firefighters' disadvantage. Nevertheless, firefighters arrived first at the scene for 95 % of assignments after 17 minutes in the median, while ambulance staff took nearly twice the time. Access to help in the immediate area is experienced as valuable to the callers, but there is also a sense of being lone and lonely with vulnerability. Instructions from T-CPR protocol were difficult to comply with both from EMDs and laypersons, especially airway control. Regardless of the quality of communication between EMD and lay people, performance of CPR did not improve. Firefighters and ambulance staff experienced a directedness of responsibility towards affected persons; simultaneously, they were each other’s support. WWFA assignment is, itself, in a gray zone between the involved organisations, and strategies are lacking for the assignment.Conclusions: WWFA assignments are an underutilized resource in individual’s local environments, where a coordinated picture of identified organisational gray zones provide better conditions for future action by the organisations involved, with increased opportunities to save lives in people's local environments.