Abstract 58: The Quality of Prearrival Cardiopulmonary Resuscitation: A Performance Review of Regional Dispatchers and Bystanders
Background: Emergency Medical Service (EMS) dispatchers and bystanders play key roles in EMS pre-arrival cardiopulmonary resuscitation (CPR). There is, however, no standardized review process for evaluating the performance of dispatchers and bystanders.
Method: We conducted a performance review of pre-arrival CPR in Nara city (276.8km2, 364,000 residents). Dispatch instruction for CPR was defined as ‘Complete Instruction’ (dispatchers recognized first compression) or ‘Incomplete Instruction’ (dispatchers failed to recognize first compression). Based on evaluation by EMS at the scene, bystander CPR continuing until EMS arrival was classified as ‘Continuous Compression’. Bystander CPR with hard and fast chest compressions was classified as ‘Good Compression’.
Results: We reviewed 197 cardiac arrest calls between Nov. 2013 and Mar. 2014. CPR was already in progress in 51 cases. In the remaining 146 cases, CPR need was recognized in 129. Due to barriers preventing CPR instruction, dispatchers provided instruction in 106 cases and bystanders performed CPR in 51 cases. Among these, dispatchers provided ‘Complete Instruction’ in 33 cases and ‘Incomplete Instruction’ in 18 cases. ‘Continuous Compression’ was performed in 37 cases and significantly more often in the ‘Complete Instruction’ than the ‘Incomplete Instruction’ group (28/33[84.8%] vs 9/18[50.0%], Chi-square test p=0.008*). The median elapsed time before first compression was 145 seconds in the ‘Continuous Compression’ with ‘Complete Instruction’ group (N=28). ‘Good Compression’ was performed in only 15 cases.
Conclusion: Our performance review found that ‘Complete Instruction’ was strongly associated with immediate and continuous bystander CPR until EMS arrival. Unfortunately, ‘Good Compression’ was not frequently provided. Performance reviews of both dispatchers and bystanders can yield useful information for improving the quality of pre-arrival CPR.
Author Disclosures: H. Fukushima: None. H. Asai: None. H. KItaoka: None. A. Iwamura: None. T. Seki: None. Y. Kawai: None. K. Norimoto: None. Y. Urisono: None. K. Nishio: None. M. Imanishi: None. K. Okuchi: None.
- © 2014 by American Heart Association, Inc.