Abstract 136: The Frequency of Dispatch Instruction for Cardiopulmonary Resuscitation on Patients Who Are Not in Cardiac Arrest
Background: Dispatch instruction for cardiopulmonary resuscitation (CPR) is the most important first link in the ‘chain of survival’. The current guideline for CPR recommends that dispatchers provide CPR instruction for unresponsive victims with abnormal breathing. However, victims not in cardiac arrest (CA), such as stroke victims, may present with abnormal breathing. Although previous studies showed that the risk of CPR on victims not in CA for serious injury is low, it is unclear how often dispatchers provide CPR instruction for those victims.
Objective: To determine the identification of CA by dispatchers based on abnormal breathing described by laypersons, and the frequency of dispatch instruction for CPR on victims not in CA.
Method: This study was conducted in the region with a population of 476,000 between August 2010 and March 2011. Information was collected prospectively through written dispatch reports.
Results: Among the 350 unresponsive victims, 273 victims were described as breathing abnormally by laypersons. The sensitivity of abnormal breathing for identification of CA was 95.7% with specificity of 42.9%. When we included only those victims with witnessed CA, the sensitivity remains high (93.2%). While dispatchers provided CPR instruction for CA victims with abnormal breathing more often (151/181, 83.4%), the frequency of CPR instruction for victims not in CA with abnormal breathing was low (41/92, 44.6%), with a p value less than 0.001 (Chi-square test).
Conclusion: This study showed that the sensitivity of identification of CA based on abnormal breathing is high, but with a relatively lower specificity than previously reported. This study also revealed that dispatchers identify victims not in CA appropriately and avoid unnecessary CPR instruction for those victims.
- © 2013 by American Heart Association, Inc.