Quality of dispatcher-assisted vs. automated external defibrillator-guided cardiopulmonary resuscitation: a randomised simulation trial

Abstract

Background Quality of hands-only cardiopulmonary resuscitation (CPR) is an important determinant of resuscitation outcome for cardiac arrest patients cared for by lay rescuers. We designed a simulation trial to assess and compare the quality of CPR among untrained lay people under two different scenarios: automated external defibrillator (AED)-guided and dispatcher-assisted CPR. Patients and methods A simulation study was performed involving 42 volunteers selected by non-probabilistic sampling. Participants were randomized into two CPR simulation scenarios with a manikin: (A) AED-guided CPR and (T) dispatcher-assisted CPR. The quality of CPR was evaluated by metric monitoring of the chest compressions and timing of actions. Content analysis of the telephone instructions was performed by two independent researchers using a checklist. Results CPR was started in 20 of the 21 cases in scenario A and in all cases in scenario T. In total, 12 053 chest compressions were applied, 57.6% corresponding to scenario A. The proportion of compressions that were of an adequate depth was low in both cases, 15.3% in scenario A vs. 31.7% in scenario T (P < 0.001), while complete chest recoil was allowed in 66 and 72% (P < 0.001) of compressions, respectively. The AED advised to shock 91 times, and shocks were delivered in all cases. Conclusions Although guided CPR helps untrained people to initiate resuscitation manoeuvres, the quality of CPR was poor in both groups. Telephone guidance improved the proportion of compressions that achieved adequate chest compression and recoil but did not optimise the compression rate.

Epidemiological characteristics and factors associated with out-of-hospital cardiac arrest attended by bystanders before ambulance arrival

“…The quality of the telephone instructions supplied by the EMS was not evaluated either. Nonetheless, previous studies lead us to presume that the quality of the resuscitation manoeuvres or the telephone instructions were suboptimal 19 , 20 , 21 . Finally, the variable corresponding to the presumable aetiology of the CA was not introduced in our model.…”

Impact of drone-specific dispatch instructions on the safety and efficacy of drone-delivered emergency medical treatments: A randomized simulation pilot study

“… [17] , [18] These pre-arrival instructions can have a significant impact on patient outcomes by increasing rates of bystander intervention and thus shortening time to treatment in medical emergencies. [3] , [19] , [20] , [21] , [22] For example, during telecommunicator CPR, the EMD will guide the caller in initiating CPR. [17] , [23] , [24] , [25] .…”

System-based interventions to improve outcome in out-of-hospital cardiac arrest patients: a Dutch experience

“…The annual incidence of Out of Hospital Cardiac Arrest (OHCA) is not exactly known and varies largely between countries from 28 to 160 per 100 000 inhabitants [1]. Quality of early cardiopulmonary resuscitation (CPR) by bystanders and ambulance staff can lead to a significant improvement in Return of Spontaneous Circulation (ROSC) and good neurological outcomes [2,3].…”

“…Quality of early cardiopulmonary resuscitation (CPR) by bystanders and ambulance staff can lead to a significant improvement in Return of Spontaneous Circulation (ROSC) and good neurological outcomes [2,3].…”