Abstract 247: The Impact of the AHA Guidelines on Dispatch-Assisted Cardiopulmonary Resuscitation

Abstract

Background: The wide variability in bystander CPR (BCPR) may be explained, in part, by how thoroughly systems implement dispatch-assisted CPR (DACPR) for out-of-hospital cardiac arrest (OHCA). The extent to which the recommendations in the recently-published AHA DACPR Scientific Advisory Statement have been implemented and their impact remains unknown. The purpose of this study was to measure the impact of implementing these recommendations in an urban 9-1-1 dispatch center. We hypothesized that this intervention would decrease several key dispatch time intervals and increase rates of BCPR. Methods: Prospective before/after observational study of Guideline-based dispatcher training on 5 performance measures: 1) time interval from call receipt to dispatcher recognition of arrest; 2) interval from call receipt to start of CPR instructions; 3) interval from call receipt to first chest compression; 4) % of cases where instructions were started; 5) % of Dispatch-Assisted BCPR (DA-BCPR). Calls were reviewed to determine the need for CPR and data entered into a structured data form. Dispatchers were trained according to AHA DACPR Guidelines using in-person and online modalities. Fisher’s exact and Kruskal-Wallis tests were used to assess statistical significance with α = 0.01 (multiple hypothesis testing). Results: Baseline: 161 suspected OHCA recordings from 10/10/10 to 3/13/11. Post intervention: 285 recordings from 11/7/11 to 1/15/12. See Table. Conclusion: In this 9-1-1 Dispatch Center, implementing the latest AHA DACPR Guidelines significantly improved the time interval to the start of CPR instructions and to first compression. In addition, there were significant increases in the proportion of OHCAs where pre-arrival CPR instructions were started and in dispatch-assisted bystander CPR rates. This intervention holds promise for improving BCPR rates on a large scale.