The feedback was concrete information about bystander action, making it possible for the bystander to modify the next resuscitation attempt. The medical dispatchers were also informed of possible warning signs for lack of coping strategy and were instructed to assess these during the debriefing interview. Prior to the study period, the debriefing guide was pilot tested on three healthcare professionals and one bystander and consequently developed. The dispatchers were introduced

to the selleck products project at a meeting where the debriefing guide was introduced and guidelines for using it were discussed. During the study period the project manager had frequent correspondence with the dispatchers and the debriefing guide was adjusted when inappropriateness was identified. Changes were communicated to the dispatchers in a weekly project newsletter and any uncertainties resolved through emails. See Fig. 1 for debriefing guide. Twelve medical dispatchers were recruited from the EMD to provide debriefing during the study period. Bystanders were recruited at the end of each call with suspected OHCA after the ambulance had arrived at the OHCA scene. The medical dispatcher offered the caller telephone

debriefing within 2–4 days after the resuscitation attempt. The caller was asked to extend this offer to all bystanders at the OHCA scene. When bystanders agreed to be contacted for debriefing, the name and telephone number were Metformin ic50 registered in the study protocol. All medical dispatchers participating

in the study were then responsible for contacting bystanders for debriefing within 2–4 days, regardless of whether the medical dispatcher had the primary OHCA call. The telephone debriefing followed the debriefing guide and was initiated by letting the bystander describe their experience with the OHCA scenario from their own perspective. Coping strategies and issues that seemed to have a deeper impact on the individual bystander were then explored. If the medical dispatcher had the impression that a bystander lacked strategies to cope with the experience, they advised the bystander to contact Protein tyrosine phosphatase his or her general practitioner. Bystanders were offered a dedicated phone number to the EMD in the end of the debriefing, in case of further questions or need of additional help To ensure inclusion of the most representative sample of bystanders, everyone participating in or witnessing the resuscitation attempt was invited to participate in the study, regardless of their role. The cardiac arrest victims’ relatives were excluded due to the hypothesis that relatives struggle with sorrow and more severe shock, and therefore may be in need of another type of help than the emergency medical dispatchers could offer.