Abstract 99: A Modified Dispatch Protocol Based on a Layperson’s Description of Breathing Styles of Sudden Cardiac Arrest Victims Is Effective in the Performance of Bystander Cardiopulmonary Resuscitation
Introduction: To increase survival from out-of-hospital cardiac arrests (OHCAs), the current guideline for resuscitation emphasizes the role of dispatcher-assisted bystander cardiopulmomary resuscitation (CPR). However, previous studies show that identification of OHCAs by dispatchers is unsatisfactory. Since the callers tend to recognize agonal respiration as a sign of life and perceive as various breathing styles, the current two-question protocol asking the callers whether the unresponsive victim is breathing normally or not is insufficient for the dispatchers to identify OHCA. The aim of this study is to verify a modified protocol for dispatcher-assisted bystander CPR based on the layperson’s description of sudden OHCA breathing styles.
Method: “Not breathing”, “weak breathing”, “unusual breathing or snoring”, and “breathing or not breathing cannot be determined” were identified as the typical layperson descriptions of sudden OHCA breathing styles, based on analysis of dispatcher records from 2007 to 2009 in Nara prefecture, Japan. According to the modified dispatch protocol, dispatchers were to provide CPR instruction when the callers report those key breathing styles. The protocol was implemented in four fire departments which covered an area including 840,000 residents. All data were collected prospectively, using Utstein Style guidelines.
Results: This protocol was carried out for 82 cases of layperson-witnessed OHCA during August to December 2011. Dispatchers instructed CPR for 59 cases of OHCA (71.9%) and callers performed bystander CPR in 41 cases (50.0%). Compared to data from August to December 2010, both the performance of dispatch instruction and dispatcher-assisted bystander CPR significantly improved with the modified dispatch protocol.
Conclusion: A modified dispatch protocol based on the layperson’s description of breathing styles of victims experiencing sudden OHCA significantly improved the performance of bystander CPR.
- © 2012 by American Heart Association, Inc.