Chien-Hsiung Huang1, Hsuan-Jui Fan2, Cheng-Yu Chien2, Chen-June Seak2, Chan-Wei Kuo2, Chip-Jin Ng2, Wen-Cheng Li3, Yi-Ming Weng4. 1. Division of Prehospital Care, Department of Emergency Medicine, Tao Yuan General Hospital, Ministry of Health and Welfare, Taiwan. 2. Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan; Chang Gung University College of Medicine, Linkou, Taiwan. 3. Department of Occupation Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan; Department of Emergency Medicine, Chang Gung Hospital, Xiamen, China. 4. Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan.
Abstract
BACKGROUND: An optimized protocol to help dispatchers identify potential cases of cardiac arrest and provide phone instructions for cardiopulmonary resuscitation (CPR) may increase the provision of bystander CPR, further improving the survival rate and neurological outcomes. OBJECTIVE: We assessed a revised dispatcher-assisted (DA)-CPR protocol with a continuous quality-improvement feature in a county fire department-based emergency medical services system. METHODS: This was a before-and-after intervention prospective study conducted in Taoyuan City, Taiwan. The participants were out-of-hospital cardiac arrest (OHCA) patients from November 2014 to February 2016. Interventional quality control started in August 2015. Approximately 10% of the telephone calls from these OHCA patients were reviewed. RESULTS: In total, 66 and 64 cases were included in the before- and after-intervention groups, respectively. No significant differences were observed in sex, age, day, and time of events, or languages spoken by the callers. After the intervention, we found significant improvements in the rates at which cardiac arrests were recognized (54.5% vs. 68.8%; p = 0.007) and normal breathing was checked (51.5% vs. 76.6%, p = 0.003). Moreover, the frequency with which DA-CPR was provided by the dispatchers improved significantly (50.0% vs. 72.7%; p = 0.046). Significant improvement in patient outcomes was observed with regard to 24-h survival (7.6% vs. 20.3%, p = 0.036) but not with regard to survival to discharge (3.0% vs. 10.9%, p = 0.076). CONCLUSIONS: The study found this DA-CPR protocol, which includes continuous quality control, is promising as it improved the successful recognition of cardiac arrests.
BACKGROUND: An optimized protocol to help dispatchers identify potential cases of cardiac arrest and provide phone instructions for cardiopulmonary resuscitation (CPR) may increase the provision of bystander CPR, further improving the survival rate and neurological outcomes. OBJECTIVE: We assessed a revised dispatcher-assisted (DA)-CPR protocol with a continuous quality-improvement feature in a county fire department-based emergency medical services system. METHODS: This was a before-and-after intervention prospective study conducted in Taoyuan City, Taiwan. The participants were out-of-hospital cardiac arrest (OHCA) patients from November 2014 to February 2016. Interventional quality control started in August 2015. Approximately 10% of the telephone calls from these OHCA patients were reviewed. RESULTS: In total, 66 and 64 cases were included in the before- and after-intervention groups, respectively. No significant differences were observed in sex, age, day, and time of events, or languages spoken by the callers. After the intervention, we found significant improvements in the rates at which cardiac arrests were recognized (54.5% vs. 68.8%; p = 0.007) and normal breathing was checked (51.5% vs. 76.6%, p = 0.003). Moreover, the frequency with which DA-CPR was provided by the dispatchers improved significantly (50.0% vs. 72.7%; p = 0.046). Significant improvement in patient outcomes was observed with regard to 24-h survival (7.6% vs. 20.3%, p = 0.036) but not with regard to survival to discharge (3.0% vs. 10.9%, p = 0.076). CONCLUSIONS: The study found this DA-CPR protocol, which includes continuous quality control, is promising as it improved the successful recognition of cardiac arrests.
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