Effect of introduction of a standardized protocol in dispatcher-assisted cardiopulmonary resuscitation

Abstract

BackgroundThe two most commonly used dispatch tools are medical priority dispatch (MPD) and criteria based dispatch (CBD), but there are countries still using non-standardized emergency call processing. We compared selected characteristics of DA-CPR before and after implementation of a standardized protocol in a non-MPD and non-CBD system. MethodsObservational study of DA-CPR recordings during 4-month periods before (PER1) and after (PER2) the standardized protocol had been implemented. Selected performance characteristics included times to event verification, identification of cardiac arrest, DA-CPR instructions, and first chest compression, which were compared between PER1 and PER2. The secondary goal was to compare survival to hospital discharge. ResultsA total of 152 call recordings with DA-CPR were evaluated in PER1 and 174 in PER2. Median times to cardiac arrest recognition were 46s in PER1 and 37s in PER2 (p=0.002), to first compression 2min 35s in PER1 and 2min 25s in PER2 (p=0.549). Admission to hospital with return of spontaneous circulation (ROSC) was achieved in 39 patients (31.9%) in PER1 and 57 (45.6%) in PER2 (p<0.05), discharge from hospital (CPC 1–2) in 9.0% and 14.4% patients in PER1 and PER2, respectively. If ventricular fibrillation was the initial rhythm, survival rate (CPC 1–2) was 32.3% in PER1 and 38.7% in PER2 (p=0.523). ConclusionImplementation of a standardized DA-CPR protocol resulted in faster identification of cardiac arrest, response team dispatching and arrival at scene. These factors were associated with a trend to better survival.