Abstract 200: Regional Difference in Emergency Medical Services Dispatcher Cardiopulmonary Resuscitation Prearrival Instructions for Patients with Out-of-Hospital Cardiac Arrest in Japan

Abstract

[Background] The 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care recommend that dispatchers should recommend cardio-pulmonary resuscitation (CPR) for unresponsive patients who are not breathing normally. This guideline also recommended special education for dispatchers. Every regional medical control system (the organization which was specially designed for presenting protocols to regional emergency medical system (EMS) and evaluating EMS operation) created dispatcher protocols to recognize cardio-pulmonary arrest and to helping CPR by bystander from July 2009 in Japan. Unfortunately, dispatchers in every regional emergency EMS could not be always specially educated. [Goal] To evaluated regional difference in EMS dispatch prearrival CPR instruction for patients with out-of-hospital cardiac arrest (OHCA). [Methods and Results] From January 1, 2005, through December 31, 2010, we conducted a prospective, population-based, observational study involving the consecutive patients across Japan who had OHCA (n=670,314). Dispatcher recommended CPR increased year by year, 33.8% of OHCA during 2005, 37.7% during 2006, 41.7% during 2007, 44.3% during 2008, 45.3% during 2009 and 46.3% during 2010 across Japan. Regional differences were shown in the figure. [Conclusion] Although EMS dispatch CPR has been increased year by year, bystander CPR recommended by EMS dispatcher has been still less than 50% of all OHCA in Japan. There were regional differences in recommendation of CPR by dispatcher across Japan. Both EMS recommendation of CPR and CPR by bystander responding to EMS recommendation were lowest in Tokyo metropolitan area. Certain detailed protocols which can be done easily even after small amount of educational time for EMS dispatcher are needed.