Outcomes of audio-instructed and video-instructed dispatcher-assisted cardiopulmonary resuscitation: a systematic review and meta-analysis

Abstract

Background The present meta-analysis of clinical and simulation trials aimed to compare video-instructed dispatcher-assisted bystander cardiopulmonary resuscitation (V-DACPR) with conventional audio-instructed dispatcher-assisted bystander cardiopulmonary resuscitation (C-DACPR). Methods We searched PubMed, Embase, Web of Science, Cochrane Collaboration databases and Scopus from inception until June 10, 2021. The primary outcomes were the prehospital return of spontaneous circulation (ROSC), survival to hospital discharge, and survival to hospital discharge with a good neurological outcome for clinical trials, and chest compression quality for simulation trials. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) indicated the pooled effect. The analyses were performed with the RevMan 5.4 and STATA 14 software. Results Overall, 2 clinical and 8 simulation trials were included in this meta-analysis. In clinical trials, C-DACPR and V-DACPR were characterised by, respectively, 11.8% vs. 24.3% of prehospital ROSC (OR = 0.46; 95% CI: 0.30, 0.69; I 2 = 66%; p < .001), 10.7% vs. 22.3% of survival to hospital discharge (OR = 0.46; 95% CI: 0.30, 0.70; I 2 = 69%; p < .001), and 6.3% vs. 16.0% of survival to hospital discharge with a good neurological outcome (OR = 0.39; 95% CI: 0.23, 0.67; I 2 = 73%; p < .001). In simulation trials, chest compression rate per minute equalled 91.3 ± 22.6 for C-DACPR and 107.8 ± 12.6 for V-DACPR (MD = −13.40; 95% CI: −21.86, −4.95; I 2 = 97%; p = .002). The respective values for chest compression depth were 38.7 ± 14.3 and 41.8 ± 12.5 mm (MD = −2.67; 95% CI: −8.35, 3.01; I 2 = 98%; p = .36). Conclusions As compared with C-DACPR, V-DACPR significantly increased prehospital ROSC and survival to hospital discharge. Under simulated resuscitation conditions, V-DACPR exhibited a higher rate of adequate chest compressions than C-DACPR. Key messages Bystander cardiopulmonary resuscitation parameters significantly depend on the dispatcher’s support and the manner of the support provided. Video-instructed dispatcher-assisted bystander cardiopulmonary resuscitation can increase the rate of prehospital return of spontaneous circulation and survival to hospital discharge. Video-instructed dispatcher-assisted bystander cardiopulmonary resuscitation improves the quality of chest compressions compared with dispatcher-assisted resuscitation without video instruction.

From hearing to seeing: medical dispatchers’ experience with use of video streaming in medical emergency calls − a qualitative study

“… 6 18 In addition, a systematic review comparing conventional dispatcher instructed CPR with video instructed CPR by dispatcher has shown increased prehospital ROSC and survival to hospital discharge in the video group. 19 …”

Video Emergency Calls in Medical Dispatching: A Scoping Review

“…Majority of analyzed evidence focuses on CPR in OHCA. Bystander CPR quality can be improved by the dispatcher's support, 19 and adding the video to the emergency calls to EMDC in a real clinical setting might have improved CPR quality 31 by improving the communication between provider and dispatcher. Nonetheless, despite some new data in the field, 34 it…”

“…[14][15][16][17][18] So far, the use of video instructions during an emergency call in out-of-hospital cardiac arrest (OHCA) is the most explored area. 19,20 Recent meta-analysis and review of studies using video-instructed dispatcher-assisted bystander cardiopulmonary resuscitation (CPR) presents improved bystander CPR quality compared to routine audio telephone CPR and better neurologic outcome and survival. 19,20 Although video emergency calls (VCs) represent a very modern option and a possible future trend in medical dispatching, technical feasibility and acceptance among callers, bystanders, and dispatchers, as well as potential problems are generally not explored in detail yet.…”

“…19,20 Recent meta-analysis and review of studies using video-instructed dispatcher-assisted bystander cardiopulmonary resuscitation (CPR) presents improved bystander CPR quality compared to routine audio telephone CPR and better neurologic outcome and survival. 19,20 Although video emergency calls (VCs) represent a very modern option and a possible future trend in medical dispatching, technical feasibility and acceptance among callers, bystanders, and dispatchers, as well as potential problems are generally not explored in detail yet. Moreover, limitations and directions of research of adding a live video from smartphones to an emergency call except from video-based dispatching in OHCA have not been reviewed so far.…”

“…Moreover, limitations and directions of research of adding a live video from smartphones to an emergency call except from video-based dispatching in OHCA have not been reviewed so far. 19,21,22 The main objective of this review is to examine the scope and the nature of research publications on the topic of medical dispatching in the prehospital emergency care with a real-time video added to the emergency call. The secondary goal is to identify research gaps and to discuss the potential directions of research efforts of VCs.…”