“You could be in the target group yourself”: Lived experiences of community first responders without a professional healthcare background in Denmark - an interpretive phenomenological study

Early cardiopulmonary resuscitation and defibrillation increase survival after out-of-hospital cardiac arrest. In Denmark, a national community first responder system dispatches nearby volunteers to initiate cardiopulmonary resuscitation and, when available, retrieve and use an automated external defibrillator before emergency medical services arrive. The system includes more than 60,000 volunteers, approximately 70% of whom do not have a professional healthcare background. Little is known about the experiences and drivers of volunteers without a professional healthcare background who serve as community first responders. This study explored the drivers and experiences of community first responders without a professional healthcare background, including their perspectives on collaboration with emergency medical services. Data were generated through a qualitative, semi-structured interview study. Ten community first responders without a professional healthcare background were recruited nationwide through social media. Interviews were analysed using Interpretative Phenomenological Analysis, which draws on phenomenology and hermeneutics to explore lived experience and meaning making. The analysis identified four superordinate themes: 1. A sense of duty, which examines why community first responders without a professional healthcare background choose to act. 2. From civilian to responder, which examines how community first responders without a professional healthcare background act under uncertainty in emergency situations. 3. Navigating relational roles in emergency response, which examines how community first responders without a professional healthcare background collaborate with professionals and peers. 4. Carrying the self into crisis, which examines how personal identity is carried into the community first responder role. Community first responders without a professional healthcare background are driven by moral duty, meaningfulness, and community belonging. Interpreted through the distinction between strong and weak altruism, the accounts of several participants point towards weak altruism, in which the wish to help others coexists with personal gains such as meaning and belonging, although elements of strong altruism were also present. In the absence of clinical expertise, they drew on experiences from work and private life. Structured preparation, clear role definitions, and systematic feedback and debriefing may enhance cooperation with the ambulance service and address needs expressed by the volunteers.