Changes to DA-CPR instructions: Can we reduce time to first compression and improve quality of bystander CPR?

Painter, Ian; Chavez, Devora; Ike, Brooke; Yip, Mei Po; Tu, Shin Ping; Bradley, Steven M; Rea, Thomas D.; Meischke, Hendrika

doi:10.1016/j.resuscitation.2014.05.015

Cited by 38 publications

(22 citation statements)

References 25 publications

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“…43 Simplified protocols and guidelines improve both the rates of bystander CPR 44 and the time to initiation. 45 This novel aspect of the resuscitation system should be measured, compared with benchmarks, and then improved as needed. 46 When these aspects of telephone CPR were combined as part of a statewide public health initiative in Arizona, significant improvements in the percentage of CPR instructions given, time to first chest compression, bystander CPR, and survival were found.…”

Section: Links In the Chain Bystander Cpr And Public-access Defibrillmentioning

confidence: 99%

Out-of-Hospital Cardiac Arrest Resuscitation Systems of Care: A Scientific Statement From the American Heart Association

McCarthy¹,

Carr²,

Sasson³

et al. 2018

Circulation

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ABSTRACT:The American Heart Association previously recommended implementation of cardiac resuscitation systems of care that consist of interconnected community, emergency medical services, and hospital efforts to measure and improve the process of care and outcome for patients with cardiac arrest. In addition, the American Heart Association proposed a national process to develop and implement evidence-based guidelines for cardiac resuscitation systems of care. Significant experience has been gained with implementing these systems, and new evidence has accumulated. This update describes recent advances in the science of cardiac resuscitation systems and evidence of their effectiveness, as well as recent progress in dissemination and implementation throughout the United States. Emphasis is placed on evidence published since the original recommendations (ie, including and since 2010). Cardiac arrest is loss of mechanical activity of the heart confirmed by the absence of signs of circulation.1 Approximately 356 461 people are treated for out-of-hospital cardiac arrest (OHCA) annually in the United States.2 One third of cases occur without any prior recognized heart disease; half occur without any prodromal symptoms.3 Despite robust systems of care for patients with trauma and rapidly evolving systems of care for patients with ST-segment-elevation myocardial infarction (STEMI) and stroke, the majority of communities do not achieve optimal survival after OHCA because of large discrepancies in resuscitation-related processes of care.4-6 As a result, survival to hospital discharge varies significantly both across different regions and by presenting rhythm. 7,8 Survival increases significantly if the OHCA is quickly recognized and responded to with prompt activation of 9-1-1, bystander-initiated cardiopulmonary resuscitation (CPR), bystander and/or basic first responder application of an automated external defibrillator (AED) before arrival of other emergency medical services (EMS) providers on scene, advanced life support, and postresuscitation care. The American Heart Association (AHA) previously recommended implementation of cardiac resuscitation systems of care that consist of interconnected community, EMS, and hospital efforts to measure and improve the process and outcome of care for patients with cardiac arrest.10 Simultaneously, the AHA proposed a national process to develop and implement evidence-based guidelines for the implementation and measurement of such systems. The 2015 AHA guidelines for CPR and emergency cardiovascular care delved deeper into the elements of an effective system of care for both OHCA and in-hospital cardiac arrest.11 This update on OHCA resuscitation systems of care describes recent advances, evidence

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Section: Links In the Chain Bystander Cpr And Public-access Defibrillmentioning

confidence: 99%

Out-of-Hospital Cardiac Arrest Resuscitation Systems of Care: A Scientific Statement From the American Heart Association

McCarthy¹,

Carr²,

Sasson³

et al. 2018

Circulation

View full text Add to dashboard Cite

show abstract

“…Its quality, however, can often be suboptimal 10, 11, 12, 16. Investigating how lay rescuers perform chest compressions under standard dispatch instruction for CPR and exploring better DACPR instruction to improve the quality of CPR are essential to improve survival with favorable neurological outcomes among sudden CA patients.…”

Section: Discussionmentioning

confidence: 99%

“…reported that optimal chest compression depth can increase the odds for survival by each 5 mm. And yet, several DACPR simulation studies have reported that the depth of chest compressions by lay rescuers rarely achieves the recommended depth 10, 11, 16. Supporting lay rescuers to perform optimal chest compression is challenging.…”

Section: Discussionmentioning

confidence: 99%

Quality of dispatch‐assisted cardiopulmonary resuscitation by lay rescuers following a standard protocol in Japan: an observational simulation study

Asai

Fukushima

Bolstad

et al. 2017

Acute Medicine & Surgery

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AimBystander cardiopulmonary resuscitation (CPR) is essential for improving the outcomes of sudden cardiac arrest patients. It has been reported that dispatch‐assisted CPR (DACPR) accounts for more than half of the incidence of CPR undertaken by bystanders. Its quality, however, can be suboptimal. We aimed to measure the quality of DACPR using a simulation study.MethodsWe recruited laypersons at a shopping mall and measured the quality of CPR carried out in our simulation. Dispatchers provided instruction in accordance with the standard DACPR protocol in Japan.ResultsTwenty‐three laypersons (13 with CPR training experience within the past 2 years and 10 with no training experience) participated in this study. The median chest compression rate and depth were 106/min and 33 mm, respectively. The median time interval from placing the 119 call to the start of chest compressions was 119 s. No significant difference was found between the groups with and without training experience. However, subjects with training experience more frequently placed their hands correctly on the manikin (84.6% versus 40.0%; P = 0.026). Twelve participants (52.2%, seven in trained and five in untrained group) interrupted chest compressions for 3–18 s, because dispatchers asked if the patient started breathing or moving.ConclusionThis current simulation study showed that the quality of DACPR carried out by lay rescuers can be less than optimal in terms of depth, hand placement, and minimization of pauses. Further studies are required to explore better DACPR instruction methods to help lay rescuers perform CPR with optimal quality.

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“…Since this study was a pilot study, the sample size was set to about 30 in each group with reference to the previous studies 8, [12][13][14][15][16] .…”

Section: Statisticsmentioning

confidence: 99%

The Effect of ten-minute dispatch-assisted cardiopulmonary resuscitation training: a randomized simulation pilot study

Fukushima

Asai

Seki

et al. 2020

Preprint

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Background Immediate bystander cardiopulmonary resuscitation (CPR) is essential for survival from sudden cardiac arrest. Current CPR guidelines recommend that dispatchers assist lay rescuers performing CPR (dispatch-assisted CPR: DACPR), which can double the frequency of bystander CPR. Laypersons, however, are not familiar with receiving CPR instructions from dispatchers. DACPR training can be beneficial for lay rescuers, but this needs to be validated. The aim of this study was to determine the effectiveness of brief DACPR training for lay rescuers in addition to a standard CPR training course. Methods We conducted a randomized DACPR simulation pilot study. Participants with no CPR training within 1 year prior to this study were assigned randomly to one of two 90-minute CPR training courses (DACPR Group: a standard CPR course including DACPR training for 10 minutes or Standard Group: a standard CPR course with a simple lecture of dispatchers’ role). In the DACPR Group, participants practiced DACPR through role-playing of a dispatcher and an emergency caller. Six months after the training, the subjects in both groups performed CPR for 2 minutes under instruction by off-duty dispatchers. Results Out of the 66 participants, 59 (DACPR Group; 30, Standard Group; 29) completed the simulation. The CPR quality was similar between the two groups. However, the median time interval between call receipt and the first dispatch-assisted compression was faster in the DACPR group (108 s vs. 129 s, p = 0.042). Conclusions This brief DACPR training can be effective for lay rescuers to start chest compressions more quickly.

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Changes to DA-CPR instructions: Can we reduce time to first compression and improve quality of bystander CPR?

Cited by 38 publications

References 25 publications

Out-of-Hospital Cardiac Arrest Resuscitation Systems of Care: A Scientific Statement From the American Heart Association

Out-of-Hospital Cardiac Arrest Resuscitation Systems of Care: A Scientific Statement From the American Heart Association

Quality of dispatch‐assisted cardiopulmonary resuscitation by lay rescuers following a standard protocol in Japan: an observational simulation study

The Effect of ten-minute dispatch-assisted cardiopulmonary resuscitation training: a randomized simulation pilot study

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