Dispatcher-assisted cardiopulmonary resuscitation protocol improves diagnosis and resuscitation recommendations for out-of-hospital cardiac arrest.

Abstract

Despite recent efforts, most people are not trained in cardiopulmonary resuscitation (CPR), which has a major impact on survival following cardiac arrest (CA). We have set up a dispatcher-assisted CPR protocol at our call centre, based on international guidelines issued in 2010. The aim of our study was to evaluate the impact of this protocol on CA diagnosis and quantity of recommendations given by telephone dispatchers to untrained witnesses. We performed a 'before and after' monocentric observational study. Data were compared before and a short time after (2 months) implementation of the protocol. We included patients presenting as an out-of-hospital CA in the presence of a witness untrained in CPR. Fisher's test was used to compare periods. P < 0.05 was considered significant. During the 8 month period before the protocol, 115 victims were potentially eligible for CPR. Diagnosis was achieved in 63.5% of cases and CPR recommendations given in 6.1%. After implementation of the protocol, 130 victims were potentially eligible for CPR. Frequency of CA diagnosis was significantly higher after the protocol with 76% of cases (P = 0.0359). Frequency of CPR recommendations given to witnesses was also significantly higher after the protocol, with a fivefold increase up to 29.2% (P < 0.0001). Implementation of a dispatcher-assisted CPR protocol was efficient in improving both CA diagnosis and CPR recommendations given to untrained witnesses for out-of-hospital CA with a very short time of dispatcher training. It is a simple and efficacious measure, at no additional cost and with the promises of improving prognosis following cardiac arrest in a centre not equipped with computerised dispatcher support programmes.