Barriers to CPR initiation and continuation during the emergency call relating to out-of-hospital cardiac arrest: A descriptive cohort study

The association of out-of-hospital cardiac arrest barriers to cardiopulmonary resuscitation initiation and continuation during the emergency call: A retrospective cohort study

“…This study utilises the same study cohort and corresponding coded data as our previously reported study, 10 briefly reproduced here for clarity. We conducted a retrospective cohort study of consecutive emergency calls received by St John Western Australia (SJ-WA) for OHCA patients between 1 January and 30 April 2021.…”

“…17 Case characteristics, and the presence of barriers to B-CPR initiation and continuation were abstracted from the call (by ESA), and the accuracy of coding was validated in 10% of cases (by TB). 10 .…”

“…In our previous study 10 we identified specific factors that delayed or prohibited the initiation or continuation of B-CPR and categorised these into eight broad barrier categories ( Table 1 ). A barrier to B-CPR initiation was defined as any factor that impeded the flow of the call, causing the call-taker to repeat, redirect or pause B-CPR instructions.…”

“… 6 However, even in systems with DA-CPR in place, case characteristics, (e.g., arrest witness status, 7 patient sex 8 and location of arrest 9 ) and other barriers also influence whether bystanders commence and continue CPR. [7] , [10] , [11] , [12] , [13] …”

“…While previous studies [7] , [12] , [13] have identified important and modifiable barriers to CPR initiation and/or continuation, they have overlooked the potential effect modification and confounding of different barriers and case characteristics. Here, we build on a previous study of emergency ambulance calls 10 where we identified eight barriers to immediate B-CPR initiation and continuation until the arrival of EMS: (1) perceived inappropriateness of B-CPR, (2) emotional distress, (3) caller reluctance, (4) bystander physical limitations, (5) patient access, (6) caller leaving the scene, (7) communication failure and (8) caller distractions. We previously found that cases had multiple barriers to CPR initiation and/or continuation co-occurring within the call, and therefore the aim of this study was to estimate the independent effects of each of the eight different barriers on caller initiation and continuation of CPR, after adjusting for case characteristics.…”