Effect of introduction of a standardized protocol in dispatcher-assisted cardiopulmonary resuscitation
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 46 s in PER1 and 37 s in PER2 (p = 0.002), to first compression 2 min 35 s in PER1 and 2 min 25 s 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.