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

Abstract

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.

Effects of cardiopulmonary resuscitation instructions on the outcomes of out‐of‐hospital cardiac arrest: An analysis of the JAAM‐OHCA registry

“…Another possible cause is spontaneous CPR, which was performed in 13.2% of patients in the No Instructions group. Lower compression depth than recommended is frequently observed in DA‐CPR, 12,13 and spontaneous CPR was reported to be of higher quality than DA‐CPR 14 . Although the differences in the beneficial effects of DA‐PCR and spontaneous CPR on the neurological outcomes of OHCA are still inconclusive, some reports have indicated better neurological outcomes in patients who underwent spontaneous CPR compared with DA‐CPR 15,16 .…”

Efetividade de vídeo educativo no conhecimento de leigos em sala de espera sobre a reanimação cardiopulmonar.

“…No Japão, apenas 40% das pessoas leigas conseguiram posicionar as mãos corretamente para realizar as compressões 21 . Compressões incorretas resultam em menor profundidade, diminuição da eficácia e comprometimento da qualidade da RCP.…”

“…Compressões incorretas resultam em menor profundidade, diminuição da eficácia e comprometimento da qualidade da RCP. Assim, é crucial que leigos sejam capacitados para que as compressões sejam realizadas no local correto 6, 21,22 .…”

“…A troca de socorrista possibilita que as compressões sejam eficientes, uma vez que a realização da RCP causa fadiga pode comprometer a qualidade do afundamento do tórax, e as pausas de trocas não devem exceder a dez segundos 6 . No Japão, em uma simulação de RCP sobre orientação telefônica, 52,2% dos participantes interromperam as compressões após dois minutos 21 . Isso indica e reforça que realizar compressões é um processo desgastante e exaustivo, o qual necessita de revezamento entre socorristas, sejam eles leigos ou profissionais.…”

Effect of Coaching with Repetitive Verbal Encouragements on Dispatch-Assisted Cardiopulmonary Resuscitation: A Randomized Simulation Study

“…Another key factor could be the quality of CPR administered by lay rescuers under dispatch instruction. Various simulation studies have shown that the quality of DACPR is generally suboptimal regarding rate, fraction, and especially depth (14)(15)(16). Thus, it is assumed that the quality of CPR by callers under the instruction of dispatchers can be the cause of, or at least contribute strongly to, the inconsistencies ( 8 , 12 ).…”