Abstract

The Aim: analysis of the influence of dispatcher assistance during cardiopulmonary resuscitation (CPR) of patients with out-of-hospital cardiac arrest (OHCA) in achieving return of spontaneous circulation (ROSC), better survival at the scene, survival to discharge, and 30-day survival.Materials and methods. This study includes epidemiological data on OHCA collected by the study protocol of the European Resuscitation Council's EuReCa_ONE study during the period October 1, 2014 — December 31, 2019. Statistical analysis was performed using SPSS Statistics v26 and GraphPad Prism v8 software packages.Results. This study included 288 patients with OHCA where CPR was provided by bystander. Dispatcher-assisted CPR (DA-CPR) occurred in 56.9% of those patients and ROSC was achieved in 31.3% of cases. Forty-four patients were hospitalized and 16 of those survived until discharge. There was no influence of dispatcher assistance on ROSC, although it resulted in slightly greater risk of the absence of ROSC (OR=1.063). Higher mortality rate to discharge occurred in DA-CPR group (P=0.013). No statistical significance was observed between DA-CPR and non-DA-CPR groups in terms of death at the scene, and 30-day survival. Dispatcher assistance during the initial CPR in hospitalized OHCA patients was a significant predictor of death outcome during hospitalization (P=0.017, OR=5.500).Conclusions. There is no significant association between the presence/absence of dispatcher assistance and ROSC or 30-day survival rate. In contrast, DA-CPR was non-significantly associated with slightly higher odds for the absence of ROSC. DA-CPR was also associated with lower survival-to-discharge rates in hospitalized OHCA patients. The study findings are the base/ground which highlights the need of implementation of existing and development of new guidelines regarding high-quality professional training of EMS dispatchers as well as basic life support education of general population.

Highlights

  • Общая выживаемость при внебольничной остановке сердца (ВБОС) остается низкой [1,2,3,4,5,6,7], что делает ее важнейшей проблемой общественного здравоохранения во всем мире [8, 9]

  • The importance of the early initiation of basic life support (BLS) measures and early use of automatic external defibrilators (AED) by bystanders before the arrival of the emergency medical service (EMS) units has been extensively explained in the literature, which is emphasized in the European Resuscitation Council (ERC) guidelines [1,2,3,4,5, 14,15,16,17,18,19,20]

  • Statistical analysis of this study was performed on 288 patients receiving bystander cardiopulmonary resuscitation (CPR) who were a part of the Serbian EuReCa registry consisting of 6266 patients with of-hospital cardiac arrest (OHCA)

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Summary

Introduction

Общая выживаемость при внебольничной остановке сердца (ВБОС) остается низкой [1,2,3,4,5,6,7], что делает ее важнейшей проблемой общественного здравоохранения во всем мире [8, 9]. Return of spontaneous circulation (ROSC) as a short-term and survival to hospital discharge as a long-term OHCA outcome are the main direct measures of successful cardiopulmonary resuscitation (CPR) as the first procedure required in these patients [10,11,12,13]. В настоящее время прилагаются большие усилия для повышения качества сердечно-легочной реанимации, выполняемой случайными прохожими, включая, помимо прочего, обучение общественности сердечнолегочной реанимации, обязательное обучение школьников и студентов сердечно-легочной реанимации, а также экстренное оповещение специально обученных лиц, не являющихся медработниками, или служб первого реагирования о случаях остановки сердца вблизи их местонахождения. Хорошо известна важность роли диспетчеров в поддержке сторонних лиц в проведении адекватной сердечно-легочной реанимации [22,23,24]

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