Abstract 92: Dispatcher Instruction in Chest Compression-Only CPR Increases Implementation of Bystander CPR: The Utstein Osaka Project
Background: Although it has been reported that dispatcher-assisted bystander CPR contributes to increasing survival from out-of-hospital cardiac arrest (OHCA), the association between actual implementation of CPR by bystanders and the type of dispatcher instruction has not been sufficiently examined.
Objectives: To investigate the association between the implementation of bystander CPR and type of dispatcher instruction (chest compression-only CPR (CC-only) or conventional CPR with chest compressions plus rescue breathing).
Methods: We registered all patients aged >=18 years suffering from OHCA of presumed cardiac origin before emergency medical service (EMS) arrival, and for whom resuscitation was attempted resuscitation by EMS personnel in Osaka Prefecture, Japan from January 2005 to December 2009. Data were prospectively collected by EMS personnel using an Utstein-style database. Odds ratios for implementation of CPR of each type of dispatcher instruction were calculated using multiple logistic regression adjusting for confounding variables.
Results: During the study period, 17,792 OHCAs of cardiac origin before EMS arrival were registered. In 7953 (44.7%) of them, the dispatcher provided CPR instruction to bystanders, and the proportion increased from 39.7% to 48.1% during the study period (P for trend=0.037). The proportion of CC-only instruction increased from 5.1% to 12.9% (P for trend=0.005). The proportion of CPR with chest compressions by bystanders was significantly higher in the CC-only CPR instruction group than in the conventional CPR instruction group (70.2% [1146/1632] vs. 62.0% [3924/6321]; adjusted odd ratio, 1.54 [95% confidence interval, 1.36-1.73]). Even if the dispatcher instructed conventional CPR with rescue breathing, only 33.0% of bystanders performed rescue breathing with chest compressions.
Conclusion: Dispatcher instruction of chest compression-only CPR is effective to increase actual CPR by bystanders.
- © 2011 by American Heart Association, Inc.