Unmeasured Interface in Emergency Cardiovascular Care: How Do Dispatch-Assisted Telephone Cardiopulmonary Resuscitation and Bystander Training Interact?

Abstract

Cardiac arrest survival remains poor, in part as a result of low rates of bystander cardiopulmonary resuscitation (B-CPR) in many communities. It has generally been assumed that training laypersons in CPR would increase the frequency of B-CPR delivery. Another means of increasing B-CPR frequency is the provision of dispatch-assisted telephone CPR, also known as telecommunicator-CPR (T-CPR), in which a 911 dispatcher provides CPR instruction over the telephone to bystanders who may need prompting or encouragement. Although numerous studies over the past decade have assessed methods to improve layperson CPR training and T-CPR independently, it is surprising that few studies have examined the interactions between these 2 important strategies (Figure). For example, it is unclear whether laypersons respond to T-CPR instructions adequately if they have not received CPR training previously. Furthermore, current CPR training courses do not typically incorporate T-CPR information (or practice with T-CPR), and whether to include such training to improve actual care delivery remains an unanswered question. Enormous efforts have been focused on both T-CPR and layperson CPR education independently over the past decades. The time is ripe to bring these …