Dispatcher-assisted bystander cardiopulmonary resuscitation in a metropolitan city: A before–after population-based study

Song, Kyoung Jun; Shin, Sang Do; Park, Chang Bae; Kim, Joo Yeong; Kim, Do Kyun; Kim, Chu Hyun; Ha, So Young; Ong, Marcus Eng Hock; Bobrow, Bentley J.; McNally, Bryan

doi:10.1016/j.resuscitation.2013.06.004

Cited by 159 publications

(96 citation statements)

References 29 publications

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“…The frequency of bystander CPR, however, still remains low, ranging from approximately 30% to 40% 2, 3. The reasons for bystanders not performing CPR are panic, lack of knowledge, being insufficiently confident to perform CPR, or the fear of unintentionally harming the patient 4, 5.…”

Section: Introductionmentioning

confidence: 99%

Performance review of regional emergency medical service pre‐arrival cardiopulmonary resuscitation with or without dispatcher instruction: a population‐based observational study

Fukushima

Kawai

Asai

et al. 2017

Acute Medicine & Surgery

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BackgroundTo investigate variations in emergency medical service (EMS) pre‐arrival cardiopulmonary resuscitation (CPR), including both bystander CPR without dispatch assistance and dispatch‐assisted CPR (DACPR).MethodsWe carried out an observational study by implementing EMS pre‐arrival CPR reports in three fire agencies. We included adult, non‐traumatic, and non‐EMS witnessed out‐of‐hospital cardiac arrests. This reporting system comprised the dispatch instruction process and bystander CPR quality based on evaluations by EMS crews who arrived on the scene. Bystander CPR was categorized as “ongoing CPR” if the bystander was performing CPR when the EMS reached the patient's side and “good‐quality CPR” if the CPR was performed proficiently. We compared the frequencies of ongoing and good‐quality CPR in the bystander CPR already started without dispatch assistance (CPR in progress) group and DACPR group.ResultsOf 688 out‐of‐hospital cardiac arrests, CPR was already started in 150 cases (CPR in progress group). Dispatcher CPR instruction was provided in 368 cases. Among these, callers started chest compressions in 162 cases (DACPR group). Ongoing CPR was performed in 220 cases and was more frequent in the DACPR group (128/162 [79.0%] versus 92/150 [61.3%], P < 0.001). Good‐quality CPR was more frequent in the CPR in progress group, but the difference was not statistically significant (36/92 [39.1%] versus 42/128 [29.0%], P = 0.888).ConclusionsOngoing CPR and good‐quality CPR were not frequent in EMS pre‐arrival CPR. Detailed analysis of dispatch instructions and bystander CPR can contribute to improvement in EMS pre‐arrival CPR.

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Section: Introductionmentioning

confidence: 99%

Performance review of regional emergency medical service pre‐arrival cardiopulmonary resuscitation with or without dispatcher instruction: a population‐based observational study

Fukushima

Kawai

Asai

et al. 2017

Acute Medicine & Surgery

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“…They found a significant increase in both chest compression (adjusted OR 6.04; 95% CI 4.72-7.72) and mouth-to mouth ventilation (adjusted OR 3.10; 95% CI 2.44-3.95) and concluded that the provision of telephone dispatcher assistance significantly increases BCPR among witnessed paediatric out-of-hospital cardiac arrests. A large beforeand-after intervention trial conducted in South Korea with 8,494 OHCAs of presumed cardiac etiology [28] done to determine the effects of DACPR on the outcomes of OHCA found that the BCPR rates increased from 190 out of 2,856 (6.7%) OHCAs in the control period (2010) to 334 out of 2689 (12.4%) in the intervention period (2011). Interestingly, they also found fluctuations in rates, (12-18%) for BCPR, in the latter 6 months, attributable to the recommendation and implementation of Compression Only CPR (COCPR) instructions in out of hospital settings.…”

Section: Influence On Bcpr Ratesmentioning

confidence: 99%

“…Although, there was a smaller effect on the improvement in favourable neurologic outcome (category 1: good cerebral performance or 2: moderate cerebral disability of the Cerebral Performance Category at 1 month) (OR 1.15; 95% CI 0.70-1.88). Song et al [28] They concluded that the DACPR protocol was associated with a significant increase in survival and neurologic outcome after OHCA. A prospective nationwide population based cohort study based in Japan, by Goto et al [29] in children with OHCA, found that the prevalence of dispatcher CPR instruction for children with OHCAs possibly influences and improves the overall 1-month survival rate.…”

Section: Influence On Survivalmentioning

confidence: 99%

The Impact of Dispatcher Assistance in the Rates and Efficacy of Bystander CPR: A Meta-analysis

Akter¹,

Hasan²,

Sana³

et al. 2017

Emerg Med

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Objective: To perform a meta-analysis of observational studies addressing whether Dispatcher Assisted Cardiopulmonary Resuscitation (DACPR), compared with independent Bystander Cardiopulmonary Resuscitation (BCPR), increases the rates of BCPR, and whether they alter survival outcomes in out-of-hospital cardiac arrests (OHCA). Methods:Relevant published articles from PubMed and Cochrane databases were studied. The baseline information and outcome data (BCPR rates, survival to hospital discharge, 1-month survival) were extracted from the out-of-hospital cardiac arrest subgroup. Meta-analyses were performed by using STATA 11.0 software. Results Conclusion:This study found that DACPR resulted in greater survival rate as compared to independent BCPR and no BCPR in OHCAs. Considering that DACPR also resulted in significantly higher rates of BCPR, DACPR should be a standard protocol for EMS systems worldwide.

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“…The rate of bystander CPR, however, generally remains low in most communities 2, 4, 5. Thus emergency medical service (EMS) dispatchers who take emergency calls may instruct callers to perform CPR 6.…”

Section: Introductionmentioning

confidence: 99%

“…Thus emergency medical service (EMS) dispatchers who take emergency calls may instruct callers to perform CPR 6. Bystander CPR undertaken by lay rescuers under dispatch instruction is called dispatch‐assisted CPR (DACPR) 4, 7, 8. It has been reported that DACPR can double the rate of bystander CPR and is associated with a better outcome for sudden CA victims 9.…”

Section: Introductionmentioning

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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Dispatcher-assisted bystander cardiopulmonary resuscitation in a metropolitan city: A before–after population-based study

Cited by 159 publications

References 29 publications

Performance review of regional emergency medical service pre‐arrival cardiopulmonary resuscitation with or without dispatcher instruction: a population‐based observational study

Performance review of regional emergency medical service pre‐arrival cardiopulmonary resuscitation with or without dispatcher instruction: a population‐based observational study

The Impact of Dispatcher Assistance in the Rates and Efficacy of Bystander CPR: A Meta-analysis

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

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