Impact of telephone cardiopulmonary resuscitation on the return of spontaneous circulation in patients with out-of-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.

Influencing factors of telephone-cardiopulmonary resuscitation in China: a qualitative exploration based on managerial perspectives

BackgroundTelephone-cardiopulmonary resuscitation (T-CPR) has been proven to systematically improve bystander CPR implementation and thus improve the survival rate of out-of-hospital cardiac arrest (OHCA) patients on a large scale. However, China has a lower proportion of cities that provide T-CPR than other countries. To promote the implementation of T-CPR in China, our study is based on managerial perspectives (Health Bureau, Fist-aid Center and other management personnel) who will play a key role in carrying out TCPR, and through a qualitative study to explore the factors affecting the providing of TCPR, especially finding out the possible obstacles, so as to promote the implementation of TCPR and play a role in promoting human health.MethodsThe semi-structured interview was conducted with managers by phenomenological research method in the qualitative study, and the data was sorted out by Nvivo 10.0 qualitative analysis software, and the data was analyzed by Colaizzi analysis to extract the theme.ResultsThe influencing factors of T-CPR in China were mainly divided into six dimensions: bystander factors, dispatcher factors, dispatching system factors, legal factors, guiding factors and financial factors.ConclusionIt is urgent to promote the implementation of T-CPR in China. We can promote it by strengthening the training of bystanders in CPR knowledge and skills, enhancing the awareness of first aid in the whole society, developing T-CPR guidance process suitable for Chines national conditions, building an intelligent pre-hospital emergency system, promoting the legislation of first aid exemption, and providing financial support from various channels.

Dispatcher Assistance in Out-of-hospital Cardiac Arrest: Approaches for Diagnosing Cardiac Arrest by Telephone

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.