Effects of dispatcher-initiated telephone cardiopulmonary resuscitation after out-of-hospital cardiac arrest: A nationwide, population-based, cohort study

Shibahashi, Keita; Ishida, Takuto; Kuwahara, Yusuke; Sugiyama, Kazuhiro; Hamabe, Yuichi

doi:10.1016/j.resuscitation.2019.08.031

“… Standard BLS starting with ventilations. 9 (Selection 4; Comparability 1; Outcome 3) Shibahashi et al 2019 [ 45 ] 01.2010–12.2016 Japan, nationwide Retrospective cohort study Fire and Disaster Management Agency’s (FDMA) nationwide registry. Adult.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 661,059 OHCA were included of which 114,284 (17%) received DA-CPR; Shibahashi et al [ 45 ] accounted for 88% of all OHCA in the review (582,483) and 76% of arrests receiving DA-CPR (86,913) (Tables 3 , 4 and 5 ). The percentage of OHCAs receiving DA-CPR varied from 2 to 65% between studies with a median of 38% and IQR of 25 to 43%.…”

Section: Resultsmentioning

confidence: 99%

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Impact of dispatcher-assisted cardiopulmonary resuscitation on neurologically intact survival in out-of-hospital cardiac arrest: a systematic review

Eberhard¹,

Linderoth

²

,

Gregers

³

et al. 2021

Scand J Trauma Resusc Emerg Med

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Background Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) increases neurologically intact survival in out-of-hospital cardiac arrest (OHCA) according to several studies. This systematic review summarizes neurologically intact survival outcomes of DA-CPR in comparison with bystander-initiated CPR and no bystander CPR in OHCA. Methods The systematic review was conducted according to the PRISMA guidelines. All studies including adult and/or pediatric OHCAs that compared DA-CPR with bystander-initiated CPR or no bystander CPR were included. Primary outcome was neurologically intact survival at discharge, one-month or longer. Studies were searched for in PubMed (MEDLINE), EMBASE, and the Cochrane Library databases. The risk of bias was evaluated using the Newcastle-Ottawa Scale. Results The search string generated 4742 citations of which 33 studies were eligible for inclusion. Due to overlapping study populations, the review included 14 studies. All studies were observational. The study populations were heterogeneous and included adult, pediatric and mixed populations. Some studies reported only witnessed cardiac arrests, arrests of cardiac ethiology, and/or shockable rhythm. The individual studies scored between six and nine on the Newcastle-Ottawa Scale of risk of bias. The median neurologically intact survival at hospital discharge with DA-CPR was 7.0% (interquartile range (IQR): 5.1–10.8%), with bystander-initiated CPR 7.5% (IQR: 6.6–10.2%), and with no bystander CPR 4.4% (IQR: 2.0–9.0%) (four studies). At one-month neurologically intact survival with DA-CPR was 3.1% (IQR: 1.6–3.4%), with bystander-initiated CPR 5.7% (IQR: 5.0–6.0%), and with no bystander CPR 2.5% (IQR: 2.1–2.6%) (three studies). Conclusion Both DA-CPR and bystander-initiated CPR increase neurologically intact survival compared with no bystander CPR. However, DA-CPR demonstrates inferior outcomes compared with bystander-initiated CPR. Early CPR is crucial, thus in cases where bystanders have not initiated CPR, DA-CPR provides an opportunity to improve neurologically intact survival following OHCA. Variability in OHCA outcomes across studies and multiple confounding factors were identified.

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“…It is important to note that the vast majority of countries reported the use of standardised dispatch protocols and dispatch-assisted CPR instructions. While there was variation in the type of instructions offered, evidence on the type of dispatch-assisted CPR instructions that should be offered is still building [ 25 , 26 ]. There is increasing evidence of the value of publicly accessible AEDs [ 27 , 28 ], therefore it was encouraging that responses indicated availability of AED registries in 21 countries.…”

Section: Discussionmentioning

confidence: 99%

Description of Emergency Medical Services, treatment of cardiac arrest patients and cardiac arrest registries in Europe

Tjelmeland

¹

,

Alm-Kruse

²

,

Gräsner

³

et al. 2020

Scand J Trauma Resusc Emerg Med

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Background Variation in the incidence, survival rate and factors associated with survival after cardiac arrest in Europe is reported. Some studies have tried to fill the knowledge gap regarding the epidemiology of out-of-hospital cardiac arrest in Europe but were unable to identify reasons for the reported differences. Therefore, the purpose of this study was to describe European Emergency Medical Systems, particularly from the perspective of country and ambulance service characteristics, cardiac arrest identification, dispatch, treatment, and monitoring. Methods An online questionnaire with 51 questions about ambulance and dispatch characteristics, on-scene management of cardiac arrest and the availability and dataset in cardiac arrest registries, was sent to all national coordinators who participated in the European Registry of Cardiac Arrest studies. In addition, individual invitations were sent to the remaining European countries. Results Participants from 28 European countries responded to the questionnaire. Results were combined with official information on population density. Overall, the number of Emergency Medical Service missions, level of training of personnel, availability of Helicopter Emergency Medical Services and the involvement of first responders varied across and within countries. There were similarities in team training, availability of key resuscitation equipment and permission for ongoing performance of cardiopulmonary resuscitation during transported. The quality of reporting to cardiac arrest registries varied, as well as the data availability in the registries. Conclusions Throughout Europe there are important differences in Emergency Medical Service systems and the response to out-of-hospital cardiac arrest. Explaining these differences is complicated due to significant variation in how variables are reported to and used in registries.

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“…While there was variation in the type of instructions offered, evidence on the type of dispatch-assisted CPR instructions that should be offered is still building. (25,26) There is increasing evidence of the value of publicly accessible AEDs, (27,28) therefore it was encouraging that responses indicated availability of AED registries in 21 countries. Most importantly, the majority of these registries were available in dispatch centres.…”

Section: Discussionmentioning

confidence: 99%

Description of Emergency Medical Services, treatment of cardiac arrest patients and cardiac arrest registries in Europe

Tjelmeland¹,

Masterson

²

,

Herlítz

³

et al. 2020

Preprint

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Background Variation in the incidence, survival rate and factors associated with survival after cardiac arrest in Europe is reported. Some studies have tried to fill the knowledge gap regarding the epidemiology of out-of-hospital cardiac arrest in Europe but were unable to identify reasons for the reported differences. Therefore, the purpose of this study was to describe European Emergency Medical Systems, particularly from the perspective of country and ambulance service characteristics, cardiac arrest identification, dispatch, treatment, and monitoring. Methods An online questionnaire with 51 questions about ambulance and dispatch characteristics, on-scene management of cardiac arrest and the availability and dataset in cardiac arrest registries, was sent to all national coordinators who participated in the European Registry of Cardiac Arrest studies. In addition, individual invitations were sent to the remaining European countries. Results Participants from 28 European countries responded to the questionnaire. Results were combined with official information on population density. Overall, the number of Emergency Medical Service missions, level of training of personnel, availability of Helicopter Emergency Medical Services and the involvement of first responders varied across and within countries. There were similarities in team training, availability of key resuscitation equipment and permission for ongoing performance of cardiopulmonary resuscitation during transported. The quality of reporting to cardiac arrest registries varied, as well as the data availability in the registries. Conclusions Throughout Europe there are important differences in Emergency Medical Service systems and the response to out-of-hospital cardiac arrest. Explaining these differences is complicated due to significant variation in how variables are reported to and used in registries.

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Effects of dispatcher-initiated telephone cardiopulmonary resuscitation after out-of-hospital cardiac arrest: A nationwide, population-based, cohort study

Cited by 13 publications

References 37 publications

Impact of dispatcher-assisted cardiopulmonary resuscitation on neurologically intact survival in out-of-hospital cardiac arrest: a systematic review

Impact of dispatcher-assisted cardiopulmonary resuscitation on neurologically intact survival in out-of-hospital cardiac arrest: a systematic review

Description of Emergency Medical Services, treatment of cardiac arrest patients and cardiac arrest registries in Europe

Description of Emergency Medical Services, treatment of cardiac arrest patients and cardiac arrest registries in Europe

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