Managing aspects of the implementation of the practice of dispatcher-assisted first aid for cardiac arrest in the Russian Federation (literature review)

Abstract

High death rates in out-of-hospital cardiac arrest are mainly associated with failure of bystanders to provide lifesaving help before arrival of medical professionals. This constitutes a major problem for present-day Russia and determines the urgent need to take managing measures aimed at maximizing involvement of the lay public into the process of resuscitation and first aid provision. Based on an analysis of contemporary scientific literature, this paper provides a justification for creation and implementation of a unified coordinated program of dispatcher-assisted cardiopulmonary resuscitation (DA-CPR), when dispatchers of emergency services provide witnesses of cardiac arrest with instructions on how to perform resuscitation over the telephone in Russia. In particular, the article describes the foreign experience of implementation of DA-CPR programs that confirms a high effectiveness of the dispatcher support as it applies to outcomes of out-of-hospital cardiac arrest; it discusses a place of DA-CPR in current international guidelines on management of cardiac arrest; and it gives an analysis of managing and legal prerequisites for implementation of DA-CPR into the daily work of emergency medical services and 112-emergency system in Russia, including the existing dispatching infrastructure for implementation of the DA-CPR program, and current legal framework that regulates management and operation of the emergency services that provide remote consultations on health protection for the public. Based on the analysis, priority managing measures were identified aimed at effective and unified implementation of the DA-CPR in Russia. For relevant literature, we searched Medline, Scopus, Web of Science, Google Scholar and Russian Science Citation Index.