Michal Plodr1, Anatolij Truhlar2, Jaroslava Krencikova3, Monika Praunova3, Vladimir Svaba3, Jiri Masek3, Dana Bejrova3, Jiri Paral4. 1. Faculty of Military Health Sciences, University of Defence, Trebesska 1575, 500 01 Hradec Kralove, Czech Republic; Emergency Medical Services of the Hradec Kralove Region, Hradecka 1690/2A, 500 12 Hradec Kralove, Czech Republic. 2. Emergency Medical Services of the Hradec Kralove Region, Hradecka 1690/2A, 500 12 Hradec Kralove, Czech Republic; Department of Anaesthesiology and Intensive Care Medicine, Charles University Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic. Electronic address: anatolij.truhlar@gmail.com. 3. Emergency Medical Services of the Hradec Kralove Region, Hradecka 1690/2A, 500 12 Hradec Kralove, Czech Republic. 4. Faculty of Military Health Sciences, University of Defence, Trebesska 1575, 500 01 Hradec Kralove, Czech Republic.
Abstract
BACKGROUND: The two most commonly used dispatch tools are medical priority dispatch (MPD) and criteria based dispatch (CBD), but there are countries still using non-standardized emergency call processing. We compared selected characteristics of DA-CPR before and after implementation of a standardized protocol in a non-MPD and non-CBD system. METHODS: Observational study of DA-CPR recordings during 4-month periods before (PER1) and after (PER2) the standardized protocol had been implemented. Selected performance characteristics included times to event verification, identification of cardiac arrest, DA-CPR instructions, and first chest compression, which were compared between PER1 and PER2. The secondary goal was to compare survival to hospital discharge. RESULTS: A total of 152 call recordings with DA-CPR were evaluated in PER1 and 174 in PER2. Median times to cardiac arrest recognition were 46s in PER1 and 37s in PER2 (p=0.002), to first compression 2min 35s in PER1 and 2min 25s in PER2 (p=0.549). Admission to hospital with return of spontaneous circulation (ROSC) was achieved in 39 patients (31.9%) in PER1 and 57 (45.6%) in PER2 (p<0.05), discharge from hospital (CPC 1-2) in 9.0% and 14.4% patients in PER1 and PER2, respectively. If ventricular fibrillation was the initial rhythm, survival rate (CPC 1-2) was 32.3% in PER1 and 38.7% in PER2 (p=0.523). CONCLUSION: Implementation of a standardized DA-CPR protocol resulted in faster identification of cardiac arrest, response team dispatching and arrival at scene. These factors were associated with a trend to better survival.
BACKGROUND: The two most commonly used dispatch tools are medical priority dispatch (MPD) and criteria based dispatch (CBD), but there are countries still using non-standardized emergency call processing. We compared selected characteristics of DA-CPR before and after implementation of a standardized protocol in a non-MPD and non-CBD system. METHODS: Observational study of DA-CPR recordings during 4-month periods before (PER1) and after (PER2) the standardized protocol had been implemented. Selected performance characteristics included times to event verification, identification of cardiac arrest, DA-CPR instructions, and first chest compression, which were compared between PER1 and PER2. The secondary goal was to compare survival to hospital discharge. RESULTS: A total of 152 call recordings with DA-CPR were evaluated in PER1 and 174 in PER2. Median times to cardiac arrest recognition were 46s in PER1 and 37s in PER2 (p=0.002), to first compression 2min 35s in PER1 and 2min 25s in PER2 (p=0.549). Admission to hospital with return of spontaneous circulation (ROSC) was achieved in 39 patients (31.9%) in PER1 and 57 (45.6%) in PER2 (p<0.05), discharge from hospital (CPC 1-2) in 9.0% and 14.4% patients in PER1 and PER2, respectively. If ventricular fibrillation was the initial rhythm, survival rate (CPC 1-2) was 32.3% in PER1 and 38.7% in PER2 (p=0.523). CONCLUSION: Implementation of a standardized DA-CPR protocol resulted in faster identification of cardiac arrest, response team dispatching and arrival at scene. These factors were associated with a trend to better survival.
Authors: Theresa M Olasveengen; Mary E Mancini; Gavin D Perkins; Suzanne Avis; Steven Brooks; Maaret Castrén; Sung Phil Chung; Julie Considine; Keith Couper; Raffo Escalante; Tetsuo Hatanaka; Kevin K C Hung; Peter Kudenchuk; Swee Han Lim; Chika Nishiyama; Giuseppe Ristagno; Federico Semeraro; Christopher M Smith; Michael A Smyth; Christian Vaillancourt; Jerry P Nolan; Mary Fran Hazinski; Peter T Morley Journal: Resuscitation Date: 2020-10-21 Impact factor: 5.262