Abstract 19018: Statewide Barriers to Dispatch-Assisted Cardiopulmonary Resuscitation Instruction
Introduction: Cardiopulmonary resuscitation (CPR) has been shown to double the odds of patient survival if performed prior to Emergency Medical Services (EMS) arrival, and dispatch-assisted CPR instruction (DA-CPRi) has been shown to augment rates of Bystander CPR provision (BCPR) and improve survival rates for out-of-hospital cardiac arrests (OHCA). Our objective is to describe the barriers to DA-CPRi provision in a single state.
Methods: We conducted a retrospective study of audio recording from OHCA calls to EMS dispatch in a large Midwestern state from 1/1/14-4/1/16. Both primary and secondary Public Safety Answering Points (PSAP) were included. OHCA dispatch recordings were reviewed by EMS agency supervisors using a standardized web tool and entered into the dispatch module of the Cardiac Arrest Registry to Enhance Survival (CARES) registry. Key temporal elements, operational and logistical barriers to DA-CPR instruction, and text comments were recorded. Text information was further categorized by study authors. Descriptive data are reported.
Results: We identified 1938 cases from 48 dispatch agencies with adequate data for review. There were physical barriers preventing provision of DA-CPRi in 190 (9.8%) cases; CPR was already in progress in 361/1748 (20.7%). Of the remaining 1387 calls, barriers to DA-CPRi were as listed in the following table:
Of the 528 cases with DA-CPRi initiated by dispatchers, 322 (61.0%) resulted in BCPR (effectively doubling the rate of BCPR). Assuming similar rates of barriers to DA-CPRi, if those 369 calls were transferred to secondary PSAPs, an additional 276 (19.9%) callers would have received DA-CPRi and 166 (12.0%) more patients may have received BCPR.
Conclusions: In this community, improving the transfer of calls from primary PSAPs for DA-CPRi may have a substantial impact on the provision of bystander CPR.
Author Disclosures: M. Shah: None. C. Bartram: None. K. Irwin: None. B. McNally: None. T. Gallagher: None. R. Swor: None.
- © 2016 by American Heart Association, Inc.