Telephone cardiopulmonary resuscitation is independently associated with improved survival and improved functional outcome after out-of-hospital cardiac arrest

Rapid recognition of cardiac arrest based on the data reported by a bystander, and delivering telephone cardiopulmonary resuscitation instructions by emergency medical services (EMS) dispatcher promote timely provision of frst aid by people who witness the emergency, and this may signifcantly inﬂuence the outcome of out-of-hospital cardiac arrest (OHCA). This review is aimed to analyze the up-to-date scientifc literature on EMS dispatcher recognition of OHCA. In particular, general concept and experience of algorithm-based diagnosis of cardiac arrest, diffculties of telephone OHCA recognition, approaches for dispatcher diagnosis quality evaluation and assurance are discussed herein. Based on the analysis results, recommendations on organizing and improving the effectiveness of EMS dispatcher recognition of cardiac arrest are formulated. The review is designed primarily for EMS and public health specialists.

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2015 Guidelines for Cardiopulmonary Resuscitation and survival after adult and paediatric out-of-hospital cardiac arrest

European Heart Journal - Quality of Care and Clinical Outcomes ◽

10.1093/ehjqcco/qcaa027 ◽

2020 ◽

Cited By ~ 2

Author(s):

Asger Granfeldt ◽

Mathias J Holmberg ◽

Michael W Donnino ◽

Lars W Andersen

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Functional Outcome ◽

Hospital Discharge ◽

Interrupted Time Series ◽

Interrupted Time Series Analysis ◽

Time Period ◽

The Usa ◽

Slope Difference ◽

Hospital Cardiac Arrest

Abstract Aims To evaluate whether the introduction of the 2015 Guidelines for Cardiopulmonary Resuscitation were associated with a change in outcomes after out-of-hospital cardiac arrest (OHCA). Methods and results Patients with OHCA were divided into adults (≥18 years) and paediatric cases (<18 years). An interrupted time-series analysis was used to compare survival before (pre-guidelines 1 January 2013 to 31 October 2015) and after (post-guidelines 1 May 2016 to 31 December 2018) introduction of the 2015 guidelines. We fitted a regression model after dividing the time-period into segments with separate intercept and slope estimates. We included 309 499 adults and 8668 children with OHCA. There was no difference in the change in survival to hospital discharge with a favourable functional outcome per year between the two periods for adults {slope difference: −0.07% [95% confidence interval (CI) −0.30 to 0.16], P = 0.55} and paediatric cases [slope difference: −0.01% (95% CI −1.35 to 1.32), P = 0.98]. Likewise, we found no immediate change in survival to hospital discharge with a favourable functional outcome between the two periods for adults [0.20% (95% CI −0.21 to 0.61), P = 0.33] and paediatric cases [−1.08 (95% CI −3.44 to 1.27), P = 0.37]. Conclusion Publication of the 2015 Guidelines for Cardiopulmonary Resuscitation was not associated with an increase in survival to hospital discharge with a favourable functional outcome after OHCA. Outcomes for OHCA have not improved the last 6 years in the USA.

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Impact of telephone cardiopulmonary resuscitation on the return of spontaneous circulation in patients with out-of-hospital cardiac arrest

Emergency Medical Service ◽

10.36740/emems202004102 ◽

2020 ◽

Vol 7 (4) ◽

pp. 256-260

Author(s):

Jerzy Jaskuła ◽

Karolina Niemczyk

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Sudden Cardiac Arrest ◽

Spontaneous Circulation ◽

Medical System ◽

Quality Monitoring ◽

Return Of Spontaneous Circulation ◽

Live Instruction ◽

Telephone Cardiopulmonary Resuscitation ◽

Hospital Cardiac Arrest

The aim: Research aim is the evaluation of return of spontaneous circulation (ROSC) ratio among the individuals with out-of-hospital sudden cardiac arrest (SCA), depending on the so-called Telephone Cardiopulmonary Resuscitation (TCPR). T-CPR is based on live instruction given by the dispatcher to incident witness, who is performing CPR efforts until the EMS team arrives on scene. Material and methods: Research was based on the analysis of 782 entries (from EMS documentation) which recorded SCA and CPR. Emergency call voice recording has been rehearsed for each case, in order to confirm the capability of recognizing SCA and providing T-CPR instructions. Data was divided into two groups and the results have been compared. The ROSC ratio for both groups (“T-CPR” and “No T-CPR”) were analyzed along with the type of incident location. Results: The research has shown that 26,4% of all SCA cases researched ended up with the ROSC. In 94% of cases the dispatcher had succeeded in encouraging the witness to perform CPR with telephone instruction (T-CPR) until the EMS team has arrived. In the “T-CPR” group, 28,7% of cases have ended with ROSC. In the “No T-CPR” group, 19,7% of cases have ended with ROSC (28,7% vs. 19,7%). Conclusions: The T-CPR should be utilized by dispatcher in the form of uniform protocol. In the process of training dispatchers there should be special emphasis on the skill of recognizing SCA upon receiving a call. The evaluation of SCA recognition, T-CPR undertaken and ROSC ratio may be an effective indicator of quality monitoring within the State Emergency Medical System.

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