Advantage of CPR-first over call-first actions for out-of-hospital cardiac arrests in nonelderly patients and of noncardiac aetiology

Abstract

Aim: To assess the benefit of immediate call or cardiopulmonary resuscitation (CPR) for survival from outof-hospital cardiac arrests (OHCAs). Results: The overall survival rates in immediate Call + CPR, Call-First, and CPR-First groups were 11.5, 12.4, and 11.5%, respectively without significant differences (p = 0.543). Subgroup analyses by multivariate logistic regression following univariate analysis disclosed that CPR-first group is more likely to survive in subgroups of noncardiac aetiology (adjusted odds ratio; 95% confidence interval, 2.01; 1.39-2.98) and of nonelderly OHCAs (1.38; 1.09-1.76). MethodsConclusions: Immediate CPR-first action followed by an emergency call without a large delay may be recommended when a bystander with sufficient skills to perform CPR witnesses OHCAs in nonelderly people and of noncardiac aetiology.Word count: 250

Executive Summary: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

“…The SysRev identified just 1 cohort study including 17 461 adults with OHCA from a national registry of 925 288 cases. 11 Analysis was limited to cases in which lay rescuers witnessed the adult cardiac arrest and performed CPR without the need for dispatcher assistance. The groups differed in many respects, and despite adjustment, residual confounding was likely.…”

The Impact of Dispatcher Assistance in the Rates and Efficacy of Bystander CPR: A Meta-analysis

“…For all other cases of OHCA, AHA has clearly stated that a call first approach gives the arrest victim the greatest survival advantage. Kamikura et al [36], in their study of 952,288 OHCAs, found that the overall survival rates in immediate Call and CPR, Call-First, and CPRFirst groups were 11.5%, 12.4%, and 11.5%, respectively. There was no significant statistical difference (p=0.543) among the groups.…”

Basismaßnahmen zur Wiederbelebung Erwachsener (Basic Life Support)

“…Nach einem systematischen Review empfiehlt das ILCOR Notfallzeugen, welche über ein Mobiltelefon verfügen, die Notrufnummer zu wählen, die Lautschaltung zu aktivieren und sofort mit der vom Leitstellendisponenten unterstützten/assistierten Wiederbelebung zu beginnen [ 1 ]. Die Empfehlung basiert auf einer Beobachtungsstudie mit geringer Evidenz und Expertenkonsens [ 32 ]. Die Beobachtungsstudie aus Japan umfasste 5446 Patienten mit OHCA und verglich Wiederbelebung zuerst mit Notruf zuerst.…”