Abstract
AimBystander cardiopulmonary resuscitation (CPR) is essential for improving the outcomes of sudden cardiac arrest patients. It has been reported that dispatch‐assisted CPR (DACPR) accounts for more than half of the incidence of CPR undertaken by bystanders. Its quality, however, can be suboptimal. We aimed to measure the quality of DACPR using a simulation study.MethodsWe recruited laypersons at a shopping mall and measured the quality of CPR carried out in our simulation. Dispatchers provided instruction in accordance with the standard DACPR protocol in Japan.ResultsTwenty‐three laypersons (13 with CPR training experience within the past 2 years and 10 with no training experience) participated in this study. The median chest compression rate and depth were 106/min and 33 mm, respectively. The median time interval from placing the 119 call to the start of chest compressions was 119 s. No significant difference was found between the groups with and without training experience. However, subjects with training experience more frequently placed their hands correctly on the manikin (84.6% versus 40.0%; P = 0.026). Twelve participants (52.2%, seven in trained and five in untrained group) interrupted chest compressions for 3–18 s, because dispatchers asked if the patient started breathing or moving.ConclusionThis current simulation study showed that the quality of DACPR carried out by lay rescuers can be less than optimal in terms of depth, hand placement, and minimization of pauses. Further studies are required to explore better DACPR instruction methods to help lay rescuers perform CPR with optimal quality.
Highlights
S UDDEN CARDIAC ARREST (CA) is a leading cause of death in industrialized nations and effective bystander cardiopulmonary resuscitation (CPR) is essential to increase patients’ chance of survival from out-of-hospital sudden CA.[1,2,3] The rate of bystander CPR, generally remains low in most communities.[2,4,5] emergency medical service (EMS) dispatchers who take emergency calls may instruct callers to perform CPR.[6]
In terms of the quality of CPR performed by lay rescuers, simulation studies have shown it is generally low[10,11,12] and the quality of dispatchassisted CPR (DACPR) can be suboptimal in real cardiac arrest cases
Correct Hand placement was more frequent in the trained group and subjects in the untrained group tended to do abdominal hand placements (84.6% versus 40.0% P = 0.026)
Summary
S UDDEN CARDIAC ARREST (CA) is a leading cause of death in industrialized nations and effective bystander cardiopulmonary resuscitation (CPR) is essential to increase patients’ chance of survival from out-of-hospital sudden CA.[1,2,3] The rate of bystander CPR, generally remains low in most communities.[2,4,5] emergency medical service (EMS) dispatchers who take emergency calls may instruct callers to perform CPR.[6]. Even in lay rescuers with CPR training experience, performance can be poor as the skills and knowledge deteriorate soon after training.[13] These lay rescuers, are still the best candidates to perform DACPR until EMS personal arrive and dispatchers should understand how they perform CPR. We hypothesized that the quality of DACPR performed by lay rescuers is suboptimal To test this hypothesis, we undertook a study to simulate lay rescuers encountering a CA situation, and observed how they perform CPR under EMS dispatch instruction
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