August 30, 2007Academic Emergency Medicine
Evaluating the Effectiveness of Dispatch‐assisted Cardiopulmonary Resuscitation Instructions
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Discussion
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Implication
Before-after study reveals dispatch-assisted CPR increases bystander CPR in cardiac arrest, highlighting agonal breathing as a major barrier.
Key Points
- To determine the prevalence of agonal breathing during out-of-hospital cardiac arrest, evaluate its impact on dispatcher recognition, and assess how dispatch-assisted CPR instructions affect bystander CPR rates.
- Conducted a before-after observational study of adult out-of-hospital cardiac arrest cases (N = 529) across two successive nine-month periods before (control, n = 295) and after (intervention, n = 234) deploying dispatch-assisted CPR instructions.
- Evaluated dispatcher diagnostic accuracy, caller-delivered resuscitation actions, time intervals to diagnosis and instructions, and victim characteristics in a tiered emergency medical services system.
- Bystander CPR rates increased from 16.7% in the control period to 26.4% in the intervention period (absolute increase 9.7%; 95% CI = 8.5% to 11.3%; p = 0.006).
- Emergency dispatchers recognized 56.3% (95% CI = 48.9% to 63.0%) of cardiac arrest cases; agonal breathing was present in 37.0% (95% CI = 30.1% to 43.9%) of cases and accounted for 50.0% (95% CI = 39.1% to 60.9%) of missed diagnoses.
- Protracted time delays were observed between call initiation and diagnosis (mean 2 minutes, 38 seconds) and during mouth-to-mouth ventilation guidance (mean 2 minutes, 5 seconds).
Cite This Study
Vaillancourt et al. (2007) studied this question.