Nikolaos Nikolaou1, Katie N Dainty2, Keith Couper3, Peter Morley4, Janice Tijssen5, Christian Vaillancourt6. 1. Department of Cardiology and Cardiac Intensive Care, Konstantopouleio General Hospital, Agias Olgas 3-5, Nea Ionia, Athens, 142 33, Greece. Electronic address: nikosnik@otenet.gr. 2. Office of Research & Innovation, North York General Hospital, Toronto, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. Electronic address: katie.dainty@utoronto.ca. 3. Warwick Medical School, University of Warwick, Coventry, UK; University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. 4. Royal Melbourne Hospital Clinical School, The University of Melbourne, Melbourne, Australia. 5. Department of Pediatrics, Schulich School of Medicine & Dentistry, Western University, London, Canada; Pediatric Intensive Care Unit, London Health Sciences Centre, London, ON, Canada. 6. Department of Emergency Medicine, University of Ottawa and Clinical Epidemiology Program, Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada.
Abstract
BACKGROUND: Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) has been reported in individual studies to significantly increase the rate of bystander CPR and survival from cardiac arrest. METHODS: We undertook a systematic review and meta-analysis to evaluate the impact of DA-CPR programs on key clinical outcomes following out-of-hospital cardiac arrest. We searched the PubMED, EMBASE, CINAHL, ERIC and Cochrane Central Register of Controlled Trials databases from inception until July 2018. Eligible studies compared systems with and without dispatcher-assisted CPR programs. The results of included studies were classified into 3 categories for the purposes of more accurate analysis: comparison of outcomes in systems with DA-CPR programs, case-based comparison of DA-CPR to bystander CPR, and case-based comparisons of DA-CPR to no CPR before EMS arrival. The GRADE system was used to assess certainty of evidence at an outcome level. We used random-effects models to produce summary effect sizes across all outcomes. RESULTS: Of 5531 citations screened, 33 studies were eligible for inclusion. All included studies were observational. Evidence certainty across all outcomes was assessed as low or very low. In system-level and patient-level comparisons, the provision of DA-CPR compared with no DA-CPR was consistently associated with improved outcome across all analyses. Comparison of DA-CPR to bystander CPR produced conflicting results. Findings were consistent across sensitivity analyses and the pediatric sub-group. CONCLUSION: These results support the recommendation that dispatchers provide CPR instructions to callers for adults and children with suspected OHCA. Review registration: PROSPERO- CRD42018091427.
BACKGROUND: Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) has been reported in individual studies to significantly increase the rate of bystander CPR and survival from cardiac arrest. METHODS: We undertook a systematic review and meta-analysis to evaluate the impact of DA-CPR programs on key clinical outcomes following out-of-hospital cardiac arrest. We searched the PubMED, EMBASE, CINAHL, ERIC and Cochrane Central Register of Controlled Trials databases from inception until July 2018. Eligible studies compared systems with and without dispatcher-assisted CPR programs. The results of included studies were classified into 3 categories for the purposes of more accurate analysis: comparison of outcomes in systems with DA-CPR programs, case-based comparison of DA-CPR to bystander CPR, and case-based comparisons of DA-CPR to no CPR before EMS arrival. The GRADE system was used to assess certainty of evidence at an outcome level. We used random-effects models to produce summary effect sizes across all outcomes. RESULTS: Of 5531 citations screened, 33 studies were eligible for inclusion. All included studies were observational. Evidence certainty across all outcomes was assessed as low or very low. In system-level and patient-level comparisons, the provision of DA-CPR compared with no DA-CPR was consistently associated with improved outcome across all analyses. Comparison of DA-CPR to bystander CPR produced conflicting results. Findings were consistent across sensitivity analyses and the pediatric sub-group. CONCLUSION: These results support the recommendation that dispatchers provide CPR instructions to callers for adults and children with suspected OHCA. Review registration: PROSPERO- CRD42018091427.
Authors: Alexander T Limkakeng; Jinny J Ye; Catherine Staton; Yih Yng Ng; Benjamin S H Leong; Nur Shahidah; Muhammad Yazid; Alexander Gordee; Maragatha Kuchibhatla; Marcus E H Ong Journal: Resuscitation Date: 2021-12-03 Impact factor: 6.251
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