Changing EMS dispatcher CPR instructions to 400 compressions before mouth-to-mouth improved bystander CPR rates

Background: To examine the impact of changing dispatcher CPR instructions (400 compressions: 2 breaths, followed by 100:2 ratio) on rates of bystander CPR and survival in adults with presumed cardiac out-of-hospital arrest (OHCA) in Melbourne, Australia. Methods: The Victorian Ambulance Cardiac Arre...

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Main Authors: Bray, Janet, Deasy, C., Walsh, J., Bacon, A., Currell, A., Smith, K.
Format: Journal Article
Published: 2011
Online Access:http://hdl.handle.net/20.500.11937/43179
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author Bray, Janet
Deasy, C.
Walsh, J.
Bacon, A.
Currell, A.
Smith, K.
author_facet Bray, Janet
Deasy, C.
Walsh, J.
Bacon, A.
Currell, A.
Smith, K.
author_sort Bray, Janet
building Curtin Institutional Repository
collection Online Access
description Background: To examine the impact of changing dispatcher CPR instructions (400 compressions: 2 breaths, followed by 100:2 ratio) on rates of bystander CPR and survival in adults with presumed cardiac out-of-hospital arrest (OHCA) in Melbourne, Australia. Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was searched for OHCA where Emergency Medical Services (EMS) attempted CPR between August 2006 and August 2009. OHCA included were: (1) patients aged ≥18 years old; (2) presumed cardiac etiology; and (3) not witnessed by EMS. Results: For the pre- and post-study periods, 1021 and 2101 OHCAs met inclusion criteria, respectively. Rates of bystander CPR increased overall (45–55%, p < 0.001) and by initial rhythm (shockable 55–70%, p < 0.001 and non-shockable 40–46%, p = 0.01). In VF/VT OHCA, there were improvements in the number of patients arriving at hospital with a return of spontaneous circulation (ROSC) (48–56%, p = 0.02) and in survival to hospital discharge (21–29%, p = 0.002), with improved outcomes restricted to patients receiving bystander CPR. After adjusting for factors associated with survival, the period of time following the change in CPR instructions was a significant predictor of survival to hospital discharge in VF/VT patients (OR 1.57, 95% CI: 1.15–2.20, p = 0.005). Conclusion: Following changes to dispatcher CPR instructions, significant increases were seen in rates of bystander CPR and improvements were seen in survival in VF/VT patients who received bystander CPR, after adjusting for factors associated with survival.
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spelling curtin-20.500.11937-431792017-09-13T15:12:27Z Changing EMS dispatcher CPR instructions to 400 compressions before mouth-to-mouth improved bystander CPR rates Bray, Janet Deasy, C. Walsh, J. Bacon, A. Currell, A. Smith, K. Background: To examine the impact of changing dispatcher CPR instructions (400 compressions: 2 breaths, followed by 100:2 ratio) on rates of bystander CPR and survival in adults with presumed cardiac out-of-hospital arrest (OHCA) in Melbourne, Australia. Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was searched for OHCA where Emergency Medical Services (EMS) attempted CPR between August 2006 and August 2009. OHCA included were: (1) patients aged ≥18 years old; (2) presumed cardiac etiology; and (3) not witnessed by EMS. Results: For the pre- and post-study periods, 1021 and 2101 OHCAs met inclusion criteria, respectively. Rates of bystander CPR increased overall (45–55%, p < 0.001) and by initial rhythm (shockable 55–70%, p < 0.001 and non-shockable 40–46%, p = 0.01). In VF/VT OHCA, there were improvements in the number of patients arriving at hospital with a return of spontaneous circulation (ROSC) (48–56%, p = 0.02) and in survival to hospital discharge (21–29%, p = 0.002), with improved outcomes restricted to patients receiving bystander CPR. After adjusting for factors associated with survival, the period of time following the change in CPR instructions was a significant predictor of survival to hospital discharge in VF/VT patients (OR 1.57, 95% CI: 1.15–2.20, p = 0.005). Conclusion: Following changes to dispatcher CPR instructions, significant increases were seen in rates of bystander CPR and improvements were seen in survival in VF/VT patients who received bystander CPR, after adjusting for factors associated with survival. 2011 Journal Article http://hdl.handle.net/20.500.11937/43179 10.1016/j.resuscitation.2011.06.018 restricted
spellingShingle Bray, Janet
Deasy, C.
Walsh, J.
Bacon, A.
Currell, A.
Smith, K.
Changing EMS dispatcher CPR instructions to 400 compressions before mouth-to-mouth improved bystander CPR rates
title Changing EMS dispatcher CPR instructions to 400 compressions before mouth-to-mouth improved bystander CPR rates
title_full Changing EMS dispatcher CPR instructions to 400 compressions before mouth-to-mouth improved bystander CPR rates
title_fullStr Changing EMS dispatcher CPR instructions to 400 compressions before mouth-to-mouth improved bystander CPR rates
title_full_unstemmed Changing EMS dispatcher CPR instructions to 400 compressions before mouth-to-mouth improved bystander CPR rates
title_short Changing EMS dispatcher CPR instructions to 400 compressions before mouth-to-mouth improved bystander CPR rates
title_sort changing ems dispatcher cpr instructions to 400 compressions before mouth-to-mouth improved bystander cpr rates
url http://hdl.handle.net/20.500.11937/43179