A before–after interventional trial of dispatcher-assisted cardio-pulmonary resuscitation for out-of-hospital cardiac arrests in Singapore

Harjanto, Sumitro; Na, May Xue Bi; Ying, Hao; Ng, Yih Yng; Doctor, Nausheen Edwin; Goh, E. Shaun; Leong, Benjamin Sieu‐Hon; Gan, Han Nee; Chia, Michael Yih Chong; Tham, Lai Peng; Cheah, Si Oon; Shahidah, Nur; Ong, Marcus Eng Hock

doi:10.1016/j.resuscitation.2016.02.014

Cited by 80 publications

(79 citation statements)

References 31 publications

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“…DACPR has contributed to an increase in bystander CPR rates in Singapore. (2) found to be associated with improved survival outcomes. (4) As is well known, survival in OHCA decreases at a rate of 7%-10% with each passing minute without CPR after cardiac arrest.…”

Section: Dispatcher-assisted Cprmentioning

confidence: 92%

Advanced Cardiac Life Support: 2016 Singapore Guidelines

Ching

Leong

Chua

et al. 2017

smedj

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Public access defibrillation PAD is another key intervention to improve the time to defi brillation for shockable rhythms in OHCA, through increasing the availability of automated external defi brillators (AEDs) in public places. Patients with shockable rhythms who received bystander defibrillation had 5.8 times the odds of survival compared to those who did not. Emergency ambulance response Prehospital emergency medical services should optimise the rapid dispatch of fi rst-responders who are trained in Basic Cardiac Life Support (BCLS) and AED use, as well as paramedics trained in advanced life support protocols, to the scene within eight minutes. This can be achieved through strategic preplacement of ambulances and related vehicular assets, as well as stratifi ed levels of responses for calls of different priority levels.Survival in OHCA is critically dependent on prompt institution of the fi rst three links of the chain of survival. Prehospital factors, including witnessed arrests, initial shockable rhythms, bystander defi brillation and emergency ambulance response times within eight minutes of collapse, have been ABSTRACT The main areas of emphasis in the Advanced Cardiac Life Support (ACLS) guidelines are: early recognition of cardiac arrest and call for help; good-quality chest compressions; early defi brillation when applicable; early administration of drugs; appropriate airway management ensuring normoventilation; and delivery of appropriate post-resuscitation care to enhance survival. Of note, it is important to monitor the quality of the various care procedures. The resuscitation team needs to reduce unnecessary interruptions to chest compressions in order to maintain adequate coronary perfusion pressure during the ACLS drill. In addition, the team needs to continually look out for reversible causes of the cardiac arrest.

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Section: Dispatcher-assisted Cprmentioning

confidence: 92%

Advanced Cardiac Life Support: 2016 Singapore Guidelines

Ching

Leong

Chua

et al. 2017

smedj

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“…It showed that out of 2,968 OHCA cases, the overall survival rate was 3.9% with good functional recovery in 2.2% of the patients and a trend suggesting improved survival outcomes with the programme. (13) BCPR rate increased from 22.4% to 42.1% (OR 2.52, 95% CI 2.09-3.04; p < 0.001) and return of spontaneous circulation rate increased signifi cantly from 26.5% to 31.2% (OR 1.26, 95% CI 1.04-1.53; p = 0.02). …”

Section: Paros Phasementioning

confidence: 97%

The Pan-Asian Resuscitation Outcomes Study (PAROS) clinical research network: what, where, why and how

Doctor

Ahmad

Pek

et al. 2017

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“…This was achieved through interviews, surveys and comprehensive reviews of audiotapes for the collection of quantitative and qualitative data to initiate a review of call-taking instructions and for the purpose of setting up an OHCA call-taking research registry. (23) These efforts were further complemented by the following: DACPR training workshops organised for all SCDF Call Centre dispatchers in 2012; secondment of four Singapore General Hospital nurses to the centre to conduct audiotape reviews; and in-house dispatcher medical training since 2013. This has contributed to the increase in bystander CPR rates in Singapore, from 22% in 2011 to 49% in 2015.…”

Section: Dispatcher-assisted Cpr In Singaporementioning

confidence: 99%

The role of dispatch in resuscitation

Leong

Ong

2017

smedj

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The role of the dispatch centre has increasingly become a focus of attention in cardiac arrest resuscitation.The dispatch centre is part of the fi rst link in the chain of survival because without the initiation of early access, the rest of the chain is irrelevant. The infl uence of dispatch can also extend to the initiation of bystander cardiopulmonary resuscitation, early defi brillation and the rapid dispatch of emergency ambulances. The new International Liaison Committee on Resuscitation, the American Heart Association and, especially, the European Resuscitation Council 2015 guidelines have been increasing their emphasis on dispatch as the key to improving out-of-hospital cardiac arrest survival.

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A before–after interventional trial of dispatcher-assisted cardio-pulmonary resuscitation for out-of-hospital cardiac arrests in Singapore

Cited by 80 publications

References 31 publications

Advanced Cardiac Life Support: 2016 Singapore Guidelines

Advanced Cardiac Life Support: 2016 Singapore Guidelines

The Pan-Asian Resuscitation Outcomes Study (PAROS) clinical research network: what, where, why and how

The role of dispatch in resuscitation

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