Objective: Out-of-hospital cardiac arrest (OHCA) in pediatrics is a devastating event associated with poor survival rates. Although telephone dispatcher-assisted cardiopulmonary resuscitation (CPR; T-CPR) instructions improve the frequency and quality of bystander CPR for OHCA in adults, this support remains undeveloped in children. Our objective was to assess the effectiveness of a pediatric T-CPR protocol in untrained and trained bystanders. Secondarily, we sought to determine the feasibility and the effectiveness of ventilation in such a protocol.Methods: Eligible adults with no CPR experience were recruited in a movie theater in Liege, as well as bachelor nursing students in Liege. All volunteers were randomly assigned either to T-CPR or to no-T-CPR using randomization. The volunteers were exposed to a pediatric manikin model cardiac arrest. On the basis of Cardiff evaluation test, data were collected to evaluate CPR performance.Results: A total of 115 volunteers were assigned to 4 groups: untrained nonguided group (n = 27), untrained guided group (n = 32), trained nonguided group (n = 26), and trained guided group (n = 30). We found an improvement in CPR performance in the guided groups. Most volunteers (81.2%) in untrained guided group and 83.3% in the trained guided group were able to give 2 ventilations after each compressions cycle.
Conclusions:In a pediatric manikin model of OHCA, T-CPR instructions including mouth-to-mouth ventilations and chest compressions produced a significant increase in resuscitation performance not only among previously untrained but also among trained volunteers.Key Words: CPR, cardiac arrest, infant, manikin, telephone, prospective study (Pediatr Emer Care 2017;33: 00-00) A lthough uncommon in children, out-of-hospital cardiac arrest (OHCA) has devastating complications.1 Indeed, the survival rate at hospital discharge rarely exceeds 8% 2 despite care being conducted in accordance with chain of survival concept. In adults, early bystander-initiated cardiopulmonary resuscitation (CPR) has been related to better neurological outcomes and higher survival rates.4 However, regardless of population, most OHCAs still do not receive any CPR before the arrival of emergency medical services.1,5 As a consequence, only 37% of infants at best actually receive early bystander CPR, whereas most OHCAs occur at home. 3 The lack of CPR knowledge or skills has been advocated to explain this low rate of CPR and subsequent poorer prognosis for OHCA occurring in private places as compared with the ones taking place in public locations. 6,7 Besides, stress, reluctance to practice mouth-to-mouth ventilation, and fear of communicable disease are other major barriers for bystander CPR practice, although these bystanders are most frequently the parents.In adults, dispatcher-assisted compression-only CPR has been demonstrated to enhance the rate of CPR attempts. This observation was the rationale for current guidelines recommending bystander chest compression-only CPR in adults. 8 However, such recom...