Abstract 15340: Dispatcher-Assisted Cardiopulmonary Resuscitation and Favorable Neurological Outcome in Cardiac Arrest
BACKGROUND The AHA 2010 guidelines for cardiopulmonary resuscitation (CPR) recommended that dispatchers should assertively provide telephone CPR instructions to rescuers for patients with suspected out-of-hospital cardiac arrest. However, it is unclear whether dispatcher-instructed CPR can improve neurological outcome.
METHODS From the data of the All-Japan Utstein Registry, a prospective, nationwide, population-based registry of out-of-hospital cardiac arrest, we extracted adult patients with bystander-witnessed out-of-hospital cardiac arrest due to cardiac etiology. The proportion and the effects of dispatcher telephone CPR instructions were investigated during 6 years. The primary endpoint was a 30-day favorable neurological outcome after cardiac arrest.
RESULTS A total of 115,466 adults with bystander-witnessed out-of-hospital cardiac arrest due to cardiac etiology were included. The proportion of dispatcher telephone CPR instructions increased year by year (from 33.4% in 2005 to 43.9% in 2010, p<0.001). Under dispatcher instructions, there were gradual increases in the patients receiving bystander CPR (from 62.2% in 2005 to 69.6% in 2010, p<0.001) and the patients with shockable cardiac arrest (21.1% in 2005, 23.4% in 2006, 23.0% in 2007, 23.3% in 2008, 24.5% in 2009, and 22.4% in 2010, p<0.001). Frequency of a 30-day favorable neurological outcome in all patients who received bystander CPR under dispatcher instructions increased year by year (3.2% in 2005, 4.2% in 2006, 5.7% in 2007, 6.0% in 2008, 6.2% in 2009 and 6.2% in 2010, p<0.001). In the subgroup of patients with shockable arrest, the frequency increased year by year (10.3% in 2005, 14.1% in 2006, 19.5% in 2007, 20.2% in 2008, 20.2% in 2009 and 22.3% in 2010, p<0.001), but the patients with non-shockable arrest had not significant increase (p=0.341).
CONCLUSION Nationwide dissemination of dispatcher telephone CPR instructions resulted in a promotion of bystander CPR, contributing to improvement of neurologically intact survival in patients with out-of-hospital cardiac arrest due to cardiac etiology, especially those with shockable cardiac arrest. However, the dispatcher instructions had not an effect on the patients with non-shockable cardiac arrest.
- © 2012 by American Heart Association, Inc.