Category: EMS
Keywords: EMS, cardiopulmonary resuscitation, CPR, emergency medical services (PubMed Search)
Posted: 8/8/2024 by Ben Lawner, MS, DO
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BACKGROUND:
Cardiac arrest is time sensitive disease. Despite significant advances in resuscitation technology such as eCPR and mechanical compression devices, early basic life support interventions (specifically bystander CPR) are strongly associated with survival. EMS systems must advocate for early initiation of bystander CPR. Dispatch Assisted CPR (DA-CPR) is one of several strategies designed to improve outcomes and encourage early compressions. To optimize survival, EMS systems should achieve a comprehensive understanding about barriers to succesful initiation of DA-CPR.
METHODS AND OUTCOMES:
49,165 patients with out of hospital cardiac arrest were eligible for inclusion the study, and over 36,000 underwent successful DA-CPR. The study's primary outcome was good neurological recovery at hospital discharge. Secondary outcomes included: prehospital return of spontaneous circulation (ROSC)and survival to hospital discharge. The authors defined successful DA-CPR when bystanders initiated compressions and continued resuscitation until the arrival of EMS.
RESULTS:
Quite a few results were consistent with prior studies. Unsuccessful DA-CPR was associated with:
Successful DA-CPR was more likely associated with the presence of family members at the scene and improved neurological recovery. Witnessed arrests were also more likely to receive successful DA-CPR. Not surpringly, patients in the successful DA-CPR group also exhibited improved survival to discharge and prehospital ROSC.
BOTTOM LINE:
Though the study is retrospective and involves a host of confounding variables, EMS systems continue to identify modifiable factors linked to the delivery of DA-CPR. Improved community CPR education and dispatcher training may contribute to higher DA-CPR rates.
BALTIMORE, MD, SPECIFIC PEARL:
Baltimore metropolitan jurisdictions are collaborating with the CPR LifeLinks program to address DA-CPR. The CPR LifeLinks program a national initiative “to help communities save more lives through implementation of telecommunicator and high performance CPR programs." https://www.911.gov/projects/cpr-lifelinks/
Park DH, Park GJ, Kim YM, Chai HS, Kim SC, Kim H, Lee SW. Barriers to successful dispatcher-assisted cardiopulmonary resuscitation in out-of-hospital cardiac arrest in Korea. Resusc Plus. 2024 Jul 19;19:100725. doi: 10.1016/j.resplu.2024.100725. PMID: 39091585; PMCID: PMC1129358
