Effects of positive dispatcher encouragement on the maintenance of bystander cardiopulmonary resuscitation quality

Abstract

Background : Implementation of dispatcher-assisted cardiopulmonary resuscitation (DACPR) has increased the likelihood of bystander CPR upon cardiac arrest. However, the quality of CPR has been found to be very low. In this study, we aimed to compare CPR quality between the current DACPR practices and the interventional instruction of adding verbal encouragement from the dispatcher. Methods : In this randomized controlled trial, we recruited adult (age ≥18) laypersons who were non-health care providers and had never received any previous verified CPR training. They were randomly selected to perform DACPR using metronome sounds (mDACPR) as per the standard protocol, or DACPR with metronome sounds along with human encouragement (mheDACPR). The ratio of accurate compression rate, depth, and complete release for each CPR phase was examined. Results: Sixty nine records (34, mDACPR; 35, mheDACPR) were taken. The median proportion of accurate chest compression rate was initially 29.5% with mDACPR, and significantly increased to 71% after 2 minutes of CPR administration ( P = .046). However, the median ratio of accurate chest compression depth was 61.5% in the first phase, and significantly decreased to 0% in the last phase ( P < .001). In contrast, for the mheDACPR group, a high accurate compression rate was maintained throughout the 2 minutes of CPR administration (91%, 100%, 100%, 100%). Conclusion : To maintain the quality of CPR administered by bystanders, continuous feedback and repeated human encouragement should be provided during DACPR. Active dispatcher intervention reduces the time required to reach an appropriate CPR rate and allows for the maintenance of accurate compression rates.

Effectiveness of a Dispatcher-Assisted Cardiopulmonary Resuscitation Program Developed by the Thailand National Institute of Emergency Medicine (NIEMS)

“…Numerous techniques have been implemented in DA-CPR protocols to increase chest compression depth, such as using verbal motivation by the dispatcher or real-time feedback strategies. 15,34,35 This study also demonstrated that non-health care provider participants who received CPR instruction and health care provider participants who received no CPR instruction had equal CPR performance and quality. This result suggests that providing frequent CPR education or training to lay rescuers would improve the quality of bystander CPR through an effective DA-CPR protocol, leading to improvements in the outcomes for patients with sudden cardiac arrest.…”

“…According to the standardized DA-CPR program, instruction was provided to participants using the speakerphone function. After the participants were instructed regarding proper posture, hand placement, compression rate, and compression depth, the dispatcher activated a metronome set to 110 beats per minute 15 using Metronome Online (EMusic Institute Corporation; Valencia, California USA). The dispatcher was blinded in another isolated room and communicated with the participants only using the provided mobile phones.…”

Reanimação cardiopulmonar por leigos – técnicas e ferramentas auxiliares: revisão integrativa

“…Intervenções comunitárias e programas de treinamento comunitário aumentaram a realização de RCP por leigos, embora não tenham aumentado significativamente a sobrevida 37,44 . Modificações nas instruções da RCP assistida por telerregulador, enfatizando o método hands-only, melhoraram a qualidade das compressões e reduziram o tempo até o início do procedimento 18,25 .…”

“…A RCP por leigos permanece como uma das principais maneiras de aumentar a sobrevida na PCR fora do ambiente hospitalar [7][8][9][10][11][12][13][14][15][16][17][18][19] . Verifica-se que várias técnicas e ferramentas estão disponíveis para auxiliar os leigos na realização de uma RCP de qualidade, aqui descritas de acordo com o tipo de intervenção proposta nos respectivos artigos.…”

The understandability and quality of telephone-guided bystander cardiopulmonary resuscitation in the Western Cape province of South Africa: A manikin-based study

“…Regarding training, mass public CPR campaigns may not be cost-effective for many LMICs, however tCPR may present to be a cost-effective alternative. Recent studies have shown that continuous telephonic encouragement and coaching by a call-taker or dispatcher over the phone may result in improved compression rates [33] , depth and overall CPR quality [34] . Considering this, it would be important to include continuous coaching in the training and implementation of OHCA telephonic recognition and tCPR guidelines.…”