Abstract 98: Effects of Dispatcher-Assisted Cardiopulmonary Resuscitation According to the AHA 2005 Guidelines for Cardiopulmonary Resuscitation
Background: Dispatcher-instructed cardiopulmonary resuscitation (CPR) by untrained bystanders had survival benefits for patients with witnessed out-of-hospital cardiac arrest. The AHA 2005 guidelines for CPR superseded the international guidelines of 2000 for CPR. It is not known whether the neurologically intact survival rate will increase if lay rescuers receive dispatcher-instructed CPR according to the AHA 2005 guidelines.
Methods: The JCS-ReSS investigated the effect of the change in dispatcher-instructed CPR procedures (hard push, fast push, allowance of complete chest recoil, and minimization of interruptions in chest compressions) to the 2005 AHA guidelines. Data of patients with out-of-hospital cardiac arrest from the all-Japan Utstein Registry of the Fire and Disaster Management Agency were analyzed. The primary end point was 30-day neurologically intact survival.
Results: Of the 19,480 bystanders who witnessed sudden cardiac arrest due to ventricular fibrillation outside the hospital, 6,638 received instructions in CPR given by dispatchers over the telephone; 2,859 received the instructions of the 2000 guidelines (the 2000 guidelines group), 3,779 received the instructions of the 2005 guidelines (the 2005 guidelines group). The performance of dispatcher-instructed CPR (chest compression plus mouth-to-mouth ventilation or chest compression only) of the 2005 guidelines group was higher than that of the 2000 guidelines group (75.1% vs.70.7%, p<0.0001), especially those with chest compression only (49.9% vs.34.2%, p<0.0001). In 30-day neurologically intact survival, a significant difference was seen between the two groups of patients receiving dispatcher-instructed CPR (18.3 % in the 2005 guidelines group vs. 11.5 % in the 2000 guidelines group, p<0.0001). A multiple logistic-regression analysis showed that the adjusted odds ratio for 30-day neurologically intact survival after dispatcher-instructed CPR procedures according to the 2005 guidelines was 1.80 (95% CI, 1. 55 to 2.08, p<0.0001).
Conclusions: Dispatcher-instructed CPR of the 2005 AHA guidelines is superior to that of the 2000 guidelines in terms of neurological benefit.
- © 2010 by American Heart Association, Inc.