Survey of a Protocol to Increase Appropriate Implementation of Dispatcher-Assisted Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrest
نویسندگان
چکیده
Background—Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) attempts to improve the management of out-of-hospital cardiac arrest (OHCA) by laypersons who are unable to recognize cardiac arrest and are unfamiliar with CPR. Therefore, we investigated the sensitivity and specificity of our new DA-CPR protocol for achieving implementation of bystander CPR in OHCA victims not already receiving bystander CPR. Methods and Results—Since 2007, we have applied a new DA-CPR protocol that uses supplementary keywords. Fire departments prospectively collected baseline data regarding DA-CPR from January 2009 to December 2011. DA-CPR was attempted in 2747 patients; of these, 417 (15.2%) did not experience cardiac arrest. The sensitivity and specificity of the 2007 protocol vs. estimated values of the previous standard protocol were 72.9% vs. 50.3% and 99.6% vs. 99.8%, respectively. We identified keywords that may be useful for detecting OHCA. Multiple logistic regression analysis revealed that the occurrence of cardiac arrest after an emergency call (odds ratio = 16.85) and placing an emergency call away from the scene of the arrest (11.04) were potentially associated with failure to provide DA-CPR. Furthermore, at-home cardiac arrest (1.61) and family members as bystanders (1.55) were associated with bystander non-compliance with DA-CPR. No complications were reported in the 417 patients who received DA-CPR but did not have cardiac arrest. Conclusions—Our 2007 protocol is safe, highly specific, and may be more sensitive than the standard protocol. Understanding the factors associated with failure of bystanders to provide DA-CPR and implementing public education will be necessary to increase the benefit of DA-CPR.
منابع مشابه
Dispatcher-assisted cardiopulmonary resuscitation and survival in cardiac arrest.
BACKGROUND Early cardiopulmonary resuscitation (CPR) improves survival in out-of-hospital cardiac arrest, and dispatcher-delivered instruction in CPR can increase the proportion of arrest victims who receive bystander CPR before emergency medical service (EMS) arrival. However, little is known about the survival effectiveness of dispatcher-delivered telephone CPR instruction. METHODS AND RESU...
متن کاملCardiopulmonary resuscitation for out of hospital cardiac arrest.
BACKGROUND Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) attempts to improve the management of out-of-hospital cardiac arrest by laypersons who are unable to recognize cardiac arrest and are unfamiliar with CPR. Therefore, we investigated the sensitivity and specificity of our new DA-CPR protocol for achieving implementation of bystander CPR in out-of-hospital cardiac arrest victim...
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BACKGROUND Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR), in which 9-1-1 dispatchers provide CPR instructions over the telephone, has been shown to nearly double the rate of bystander CPR. We sought to identify factors that hampered the identification of cardiac arrest by 9-1-1 dispatchers and prevented or delayed the provision of dispatcher-assisted CPR chest compressions. METHO...
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BACKGROUND The impact of dispatcher-assisted bystander cardiopulmonary resuscitation (CPR) on neurological outcomes in children is unclear. We investigated whether dispatcher-assisted bystander CPR shows favorable neurological outcomes (Cerebral Performance Category scale 1 or 2) in children with out-of-hospital cardiac arrest (OHCA). METHODS AND RESULTS Children (n=5009, age<18 years) with O...
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STUDY OBJECTIVE We study the effect of a nationwide dispatcher-assisted cardiopulmonary resuscitation (CPR) program on out-of-hospital cardiac arrest outcomes by arrest location (public and private settings). METHODS All emergency medical services (EMS)-treated adults in Korea with out-of-hospital cardiac arrests of cardiac cause were enrolled between 2012 and 2013, excluding cases witnessed ...
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