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Dispatcher CPR Instructions Across the Age Continuum

Published online by Cambridge University Press:  26 April 2018

Kristi L. Weinmeister
Affiliation:
Medical College of Wisconsin, Milwaukee, WisconsinUSA
E. Brooke Lerner*
Affiliation:
Medical College of Wisconsin, Milwaukee, WisconsinUSA
Clare E. Guse
Affiliation:
Medical College of Wisconsin, Milwaukee, WisconsinUSA
Khalid A. Ateyyah
Affiliation:
Taibah University, College of Medicine, Madinah, Saudi Arabia
Ronald G. Pirrallo
Affiliation:
University of South Carolina School of Medicine Greenville, Greenville, South CarolinaUSA
*
Correspondence: E. Brooke Lerner, PhD, FAEMS Department of Emergency Medicine Medical College of Wisconsin The HUB, 3rd Floor 8701 W. Watertown Plank Road Milwaukee, Wisconsin 53226 USA E-mail: [email protected]

Abstract

Background

Survival rates following out-of-hospital cardiac arrest (OHCA) increase two to three times when cardiopulmonary resuscitation (CPR) is started by bystanders, as compared to starting CPR when Emergency Medical Services (EMS) arrives. Municipalities that have implemented dispatcher-assisted bystander CPR programs have seen increased rates of bystander CPR. Cardiopulmonary resuscitation instructions are given for victims of all ages, but it is unknown if offering instructions results in similar rates of EMS-documented bystander CPR across the age continuum in these municipalities.

Objectives

The aim of this study was to determine if there is a difference in EMS-documented bystander CPR rates based on the age group of the OHCA victim when dispatcher CPR instructions are available in the community.

Methods

This was a three-year, retrospective chart review of OHCA patients in two municipalities within a single county that provided dispatcher-assisted CPR instructions. Bystander CPR and patient age were determined based on EMS documentation. Age was stratified into three groups: child (0-12 years), adult (13-54 years), and geriatric (≥55 years). Chi square was used to compare the rate of bystander CPR in each age group.

Results

During the study period, 1,993 patients were identified as being in OHCA at the time of EMS arrival. The overall bystander CPR rate was 10%. The highest rate of bystander CPR was in the child age group (19%). The lowest rate of bystander CPR was in the geriatric age group (9%). There was a statistically significant difference between age groups (P≤.01).

Conclusions

The rate of EMS-documented bystander CPR was low, even though these municipalities provided dispatcher-assisted CPR instructions. The highest rates of bystander CPR were observed in children (0-12 years). Future investigations should determine why this occurs and if there are opportunities to modify dispatcher coaching based on patient age so that bystander CPR rates improve.

WeinmeisterKL, LernerEB, GuseCE, AteyyahKA, PirralloRG. Dispatcher CPR Instructions Across the Age Continuum. Prehosp Disaster Med. 2018;33(3):342–345.

Type
Brief Report
Copyright
© World Association for Disaster and Emergency Medicine 2018 

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Footnotes

Conflicts of interest/funding: Research reported in this publication was supported in part by the National Institute on Aging of the National Institutes of Health (Bethesda, Maryland USA) under Award Number T35AG029793. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors have no relevant financial conflicts of interest to report.

References

1. American Heart Association CPR and First Aid. Heart Disease and Stroke Statistics for 2013: 2016 Update. http://www.cpr.heart.org/AHAECC/CPRAndECC/General/UCM_477263_Cardiac-Arrest-Statistics.jsp. Accessed January 15, 2017.Google Scholar
2. Lerner, EB, Rea, TD, Bobrow, BJ, et al. Emergency Medical Service dispatch cardiopulmonary resuscitation prearrival instructions to improve survival from out-of-hospital cardiac arrest, a scientific statement from the American Heart Association. Circulation. 2012;125(4):648-655.Google Scholar
3. Public Health – Seattle and King County. 2016 King County EMS Annual Report. http://www.kingcounty.gov/depts/health/~/media/depts/health/emergency-medical-services/documents/reports/2016-Annual-Report.ashx. Accessed January 15, 2017.Google Scholar
4. Public Health – Seattle and King County. King County has world’s highest survival rate for cardiac arrest. http://www.kingcounty.gov/depts/health/news/2014/May/19-cardiac-survival.aspx. Accessed January 15, 2017.Google Scholar
5. Bobrow, BJ, Spaite, D, Vadeboncoeur, TF, et al. Implementation of a regional telephone cardiopulmonary resuscitation program and outcomes after out-of-hospital cardiac arrest. JAMA Cardiol. 2016;1(3):294-302.Google Scholar
6. Harjanto, S, Na, MX, Hao, Y, et al. A before-after interventional trial of dispatcher-assisted cardio-pulmonary resuscitation for out-of-hospital cardiac arrests in Singapore. Resuscitation. 2016;102:85-93.Google Scholar
7. Go, A, Mozaffarian, D, Roger, V, et al. Heart disease and stroke statistics-2013 update: a report from the American Heart Association. Circulation. 2013;127(1):e226.Google Scholar
8. Holmberg, M, Holmberg, S, Herliz, J. Factors modifying the effect of bystander cardiopulmonary resuscitation on survival in out of hospital cardiac arrest patients in Sweden. Eur Heart J. 2001;22(6):511-519.Google Scholar
9. Sasson, C, Magrid, D, Chan, P, et al. Association of neighborhood characteristics with bystander-initiated CPR. New Engl J Med. 2012;376(17):1607-1615.Google Scholar
10. Platz, E, Scheatzle, MD, Pepe, PE, Dearwater, SR. Attitudes towards CPR training and performance in family members of patients with heart disease. Resuscitation. 2000;47(3):273-280.Google Scholar
11. Swor, RA, Khan, I, Domeier, R, Honeycutt, L, Chu, K, Compton, S. CPR training and CPR performance: do CPR-trained bystanders perform CPR? Acad Emerg Med. 2006;13(6):596-601.Google Scholar
12. Lerner, EB, Sayre, MR, Brice, JH, et al. Cardiac arrest patients rarely receive chest compressions before ambulance arrival despite the availability of pre-arrival CPR instructions. Resuscitation. 2008;77(1):51-56.Google Scholar
13. Naim, MY, Burke, RV, McNally, BF, et al. Association of bystander cardiopulmonary resuscitation with overall and neurologically favorable survival after pediatric out-of-hospital cardiac arrest in the United States. JAMA Pediatr. 2017;171(2):133-141.Google Scholar
14. Hauff, SR, Rea, TD, Culley, LL, Becker, L, Eisenberg, MS. Factors impeding dispatcher-assisted telephone cardiopulmonary resuscitation. Ann Emerg Med. 2003;42(6):731-737.Google Scholar
15. Clawson, JJ, Dernocoeur, KB, Murray, C. Strategies for Good Telecommunication. Principles of Emergency Medical Dispatch. 5th edition. Salt Lake City, Utah USA: Hudson Printing Priority Press; 2014; chapter 2.8.Google Scholar
16. Tanaka, Y, Taniguchi, J, Wato, Y, et al. The continuous quality improvement project for telephone-assisted instruction of cardiopulmonary resuscitation increased the incidence of bystander CPR and improved the outcomes of out-of-hospital cardiac arrests. Resuscitation. 2012;83(10):1235-1241.Google Scholar
17. Vaillancourt, C, Charette, M, Stiell, K, et al. An evaluation of 911 calls to assess the effectiveness of dispatch-assisted cardiopulmonary resuscitation (CPR) instructions: design and methodology. BMC Emerg Med. 2008;8:12.Google Scholar