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Director Floris Italianer of the Dutch Heart Foundation: ‘The more people sign up as first responders, the better’

20 January 2017

If the right aid is always given within the first six minutes of a cardiac arrest, many more people can survive cardiac arrests. First response is vital in this. The more involved civilians that sign up as first responders, the better. So says director Floris Italianer of the Dutch Heart Foundation in an interview with Stan the CPR Network.

Fewer fatalities

The Dutch Heart Foundation is dedicated to recruiting first responders. Among other things, the Heart Foundation brings to attention the need for first response and a good call-out system. In over fifty years, the Heart Foundation invested four hundred million euros in matters like research, prevention and treatment methods. The result is a rigorous decline in the number of deaths from cardiovascular disease: from one in two fatalities in the sixties to one in four now.

Healthy living

At the time the Heart Foundation was founded, there was hardly anything known about the importance of healthy living: exercising, eating right and no smoking. Partly thanks to the efforts of doctors, researchers, education, government and donors, fewer and fewer people have their lives suddenly and drastically changed by a stroke, coronary or circulatory arrest.

Public profit

The economic results aren’t bad either. Research conducted by the Erasmus University showed that every euro invested generated a public profit of fourteen euros.

6 minute zone

This is the ultimate goal for the next fifty years: rid the world of all cardiovascular disease. The Heart Foundation is committing itself to four key points. One of those is the 6 minute zone: everyone who suffers cardiac arrest outside of a hospital must be resuscitated as soon as possible and always within six minutes in order to maximise survival chances.

First response

We want to reach this goal not in fifty, but in five years. First response is essential in this. Because ambulances only have a legal deadline of fifteen minutes.


Another key point of policy is prevention. For instance, smoking is disastrous to heart and blood vessels. The number of smokers has significantly decreased over the past decades, among young people as well. Obesity in children and youth is increasing, which is a huge problem. That is why the Heart Foundation is targeting much of its prevention at young people.

Control of your own life

The third key point remains structural research, the fourth is ‘control of your own life’. The time that doctors dictated treatments is behind us. Patients, partly thanks to the Internet, are getting more insight and want a say in their treatment. The Heart Foundation offers individual guidance with questions. We get about twelve thousand phone calls about this every year.


We also want to focus more on research based on the data from AEDs. The defibrillators record all data. This data can be a significant contribution, both in the treatment of individual patients and collectively. Take the ARREST research led by cardiologist Ruud Koster for instance. It helps to detect patters in for instance the causes of cardiac arrests.


Everyone who is a first responder, must be directly linked to a first response system. There are always some ‘white spots’ in the Netherlands, regions with ambulance control rooms who do not work with first responders yet. This truly worries me. That is why we are having conversations with parties involved. Based on these conversations, I am convinced things will work out.

No obligations

It is not up to the government to force dispatch centres and civilians to take part in the first response system. Civilian participation comes from the people themselves. By definition, that works better than people being forced from higher up.

First responders

Gains can still be made in maximising first responders’ flexibility in indicating availability and location. Ideally, a completely GPS-based system would be created, where only first responders actually within a six minute zone from the victim get an alert.


First responders have to be optimally prepared for their task, so that they don’t get stressed when they are actually called out. And after performing emergency assistance, they have to be supervised correctly. Bonds between first responders and with the organisation ensure that they feel structurally involved.