Abstract 108: The Change and Effect of Dispatcher Telephone Instructions for Cardiopulmonary Resuscitation with Chest Compressions Only
BACKGROUND The 2010 AHA guidelines for CPR recommended that dispatchers should instruct untrained lay rescuers to provide chest compression-only CPR for adults with out-of-hospital cardiac arrest. We investigated the change and the effect of dispatcher telephone instruction of chest compression-only CPR.
METHODS From the data of the All-Japan Utstein Registry, a prospective, nationwide, population-based registry of out-of-hospital cardiac arrest, we extracted the adult patients with out-of hospital cardiac arrest due to cardiac etiology for whom dispatchers initiated CPR instruction to bystanders in the years from 2005 to 2010. The proportion of dispatcher-telephone chest compression-only CPR was calculated from all dispatcher-telephone CPR instructions. 30-day favorable neurological outcome after cardiac arrest was analyzed in all patients receiving dispatcher-telephone CPR instructions and the subgroups of patients receiving chest-compression only CPR, conventional CPR and no CPR.
RESULTS Of the 45,587 patients who met the inclusion criteria, 21,032 received dispatcher-telephone chest-compression only CPR, 9,897 dispatcher-telephone conventional CPR, and 14,636 no CPR. The proportions of dispatcher-telephone chest compression-only CPR increased year by year (from 29.8% in 2005 to 54.7% in 2010, p<0.0001). On the other hand, the proportions of dispatcher-telephone conventional CPR decreased year by year (from 32.4% in 2005 to 14.8% in 2010, p<0.0001). Among patients receiving dispatcher-telephone CPR instructions, the frequency of 30-day favorable neurological outcome increased year by year in the whole cohort (2.9% in 2005, 3.4% in 2006, 4.9% in 2007, 5.1% in 2008, 5.3% in 2009, and 5.1% in 2010, p<0.0001) and in the shockable arrest (10% in 2005, 12.3% in 2006, 17.5% in 2007, 18.1% in 2008, 18.6% in 2009, and 19.7% in 2010, p<0.0001). Adjusted odds ratio for favorable neurological outcome after dispatcher-telephone chest compression-only CPR was 1.7 (95% CI, 1.5 to2.0) in patients whose bystanders received any dispatcher-telephone CPR instructions.
CONCLUSION The performance of dispatcher-telephone chest compression-only CPR increased year by year, contributing to improvement of favorable neurological outcome.
- Cardiopulmonary resuscitation
- Cardiac arrest
- Emergency care
- Post cardiac arrest care
- Ventricular fibrillation
- © 2012 by American Heart Association, Inc.