Factors associated with quality of bystander CPR: The presence of multiple rescuers and bystander-initiated CPR without instruction

Takei, Yutaka; Nishi, Taiki; Matsubara, Hiroki; Hashimoto, Masaaki; Inaba, Hideo

doi:10.1016/j.resuscitation.2013.12.019

Cited by 70 publications

(56 citation statements)

References 34 publications

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“…However, dispatcher instruction for CPR and bystander CPR are more complex than simple yes/no categorical variables. Both dispatchers and bystanders show wide variations in performance which can affect outcomes 10, 11. To improve EMS pre‐arrival CPR, these performances should be evaluated.…”

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

View full text Add to dashboard Cite

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“…It is known that female gender is associated with poor quality of CPR 18. While in real life the majority of bystanders are reported to be female,27, 28 still this point needs to be considered when it comes to generalization of our study findings. Third, this is an observational simulation study and it is unknown how actual lay rescuers behave and perform CPR in real cardiac arrest cases.…”

Section: Discussionmentioning

confidence: 71%

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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“…First, the information regarding the number of bystanders involved in the BLS action in the initial phase of rescue was not obtained. Reportedly, the quality of BCPR and outcome of OHCAs were affected by the number of rescuers [26,30]. Our classification of the immediate BLS actions was based only on the time interval.…”

Section: Discussionmentioning

confidence: 99%

Advantage of CPR-first over call-first actions for out-of-hospital cardiac arrests in nonelderly patients and of noncardiac aetiology

et al. 2015

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Aim: To assess the benefit of immediate call or cardiopulmonary resuscitation (CPR) for survival from outof-hospital cardiac arrests (OHCAs). Results: The overall survival rates in immediate Call + CPR, Call-First, and CPR-First groups were 11.5, 12.4, and 11.5%, respectively without significant differences (p = 0.543). Subgroup analyses by multivariate logistic regression following univariate analysis disclosed that CPR-first group is more likely to survive in subgroups of noncardiac aetiology (adjusted odds ratio; 95% confidence interval, 2.01; 1.39-2.98) and of nonelderly OHCAs (1.38; 1.09-1.76). MethodsConclusions: Immediate CPR-first action followed by an emergency call without a large delay may be recommended when a bystander with sufficient skills to perform CPR witnesses OHCAs in nonelderly people and of noncardiac aetiology.Word count: 250

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Factors associated with quality of bystander CPR: The presence of multiple rescuers and bystander-initiated CPR without instruction

Cited by 70 publications

References 34 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

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

Advantage of CPR-first over call-first actions for out-of-hospital cardiac arrests in nonelderly patients and of noncardiac aetiology

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