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Effectiveness of a Dispatcher-Assisted Cardiopulmonary Resuscitation Program Developed by the Thailand National Institute of Emergency Medicine (NIEMS)

Published online by Cambridge University Press:  14 October 2021

Chuenruthai Angkoontassaneeyarat ,
Chaiyaporn Yuksen Open the ORCID record for Chaiyaporn Yuksen [Opens in a new window] ,
Chetsadakon Jenpanitpong ,
Pemika Rukthai ,
Marisa Seanpan ,
Dumrongsak Pongprajak  and
Thanakorn Laksanamapune
Chuenruthai Angkoontassaneeyarat
Affiliation:
Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Chaiyaporn Yuksen*
Affiliation:
Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Chetsadakon Jenpanitpong
Affiliation:
Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Pemika Rukthai
Affiliation:
Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Marisa Seanpan
Affiliation:
Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Dumrongsak Pongprajak
Affiliation:
Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Thanakorn Laksanamapune
Affiliation:
Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
*
Correspondence: Chaiyaporn Yuksen Department of Emergency Medicine Faculty of Medicine Ramathibodi Hospital Mahidol University 270 Rama VI Road, Thung Phaya Thai, Ratchathewi Bangkok, Thailand, 10400 E-mail: chaipool0634@hotmail.com
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Abstract

Background:

Out-of-hospital cardiac arrest (OHCA) is a life-threatening condition with an overall survival rate that generally does not exceed 10%. Several factors play essential roles in increasing survival among patients experiencing cardiac arrest outside the hospital. Previous studies have reported that implementing a dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) program increases bystander CPR, quality of chest compressions, and patient survival. This study aimed to assess the effectiveness of a DA-CPR program developed by the Thailand National Institute for Emergency Medicine (NIEMS).

Methods:

This was an experimental study using a manikin model. The participants comprised both health care providers and non-health care providers aged 18 to 60 years. They were randomly assigned to either the DA-CPR group or the uninstructed CPR (U-CPR) group and performed chest compressions on a manikin model for two minutes. The sequentially numbered, opaque, sealed envelope method was used for randomization in blocks of four with a ratio of 1:1.

Results:

There were 100 participants in this study (49 in the DA-CPR group and 51 in the U-CPR group). Time to initiate chest compressions was statistically significantly longer in the DA-CPR group than in the U-CPR group (85.82 [SD = 32.54] seconds versus 23.94 [SD = 16.70] seconds; P <.001). However, the CPR instruction did not translate into better performance or quality of chest compressions for the overall sample or for health care or non-health care providers.

Conclusion:

Those in the CPR-trained group applied chest compressions (initiated CPR) more quickly than those who initiated CPR based upon dispatch-based CPR instructions.

Keywords

basic cardiac life supportcardiopulmonary resuscitationemergency medical dispatchEmergency Medical Serviceout-of-hospital cardiac arrest
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 6 , December 2021 , pp. 702 - 707
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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References

Berdowski, J, Berg, RA, Tijssen, JG, et al. Global incidences of out-of- hospital cardiac arrest and survival rates: systematic review of 67 prospective studies. Resuscitation. 2010;81(11):1479–1487.CrossRefGoogle ScholarPubMed
Panchal, AR, Bartos, JA, Cabañas, JG, et al. Part 3: adult basic and advanced life support: 2020 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2020;142(16_suppl_2):S366–368.CrossRefGoogle ScholarPubMed
Kragholm, K, Wissenberg, M, Mortensen, RN, et al. Bystander efforts and 1-year outcomes in out-of-hospital cardiac arrest. N Engl J Med. 2017;376(18):1737–1747.CrossRefGoogle ScholarPubMed
Tanaka, H, Ong, MEH, Siddiqui, FJ, et al. Modifiable factors associated with survival after out-of-hospital cardiac arrest in the Pan-Asian Resuscitation Outcomes Study. Ann Emerg Med. 2018;71(5):608–617.CrossRefGoogle ScholarPubMed
Panchal, AR, Berg, KM, Cabañas, JG, et al. 2019 American Heart Association focused update on systems of care: dispatcher-assisted cardiopulmonary resuscitation and cardiac arrest centers: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2019;140(24):e895–903.Google Scholar
Song, KJ, Shin, SD, Park, CB, et al. Dispatcher-assisted bystander cardiopulmonary resuscitation in a metropolitan city: a before–after population-based study. Resuscitation. 2014;85(1):34–41.CrossRefGoogle Scholar
Goto, Y, Maeda, T, Goto, Y. Impact of dispatcher-assisted bystander cardiopulmonary resuscitation on neurological outcomes in children with out-of-hospital cardiac arrests: a prospective, nationwide, population-based cohort study. J Am Heart Assoc. 2014;3(3):e000499.CrossRefGoogle ScholarPubMed
Ro, YS, Shin, SD, Song, KJ, et al. Effects of dispatcher-assisted cardiopulmonary resuscitation on survival outcomes in infants, children, and adolescents with out-of-hospital cardiac arrests. Resuscitation. 2016;108:20–26.CrossRefGoogle ScholarPubMed
Wang, J, Zhang, H, Zhao, Z, et al. Impact of dispatcher-assisted bystander cardiopulmonary resuscitation with out-of-hospital cardiac arrest: a systemic review and meta-analysis. Prehosp Disaster Med. 2020;35(4):372–381.CrossRefGoogle ScholarPubMed
Lerner, EB, Rea, TD, Bobrow, BJ, et al. Emergency medical service dispatch cardiopulmonary resuscitation prearrival instructions to improve survival from out-of-hospital cardiac arrest: a scientific statement from the American Heart Association. Circulation. 2012;125(4):648–655.CrossRefGoogle ScholarPubMed
Chen, KY, Ko, YC, Hsieh, MJ, et al. Interventions to improve the quality of bystander cardiopulmonary resuscitation: a systematic review. PLoS One. 2019;14(2):e0211792.CrossRefGoogle ScholarPubMed
Thailand National Institute of Emergency Medicine. Emergency Medical Triage Protocol and Criteria Based Dispatch. Nonthaburi: Thailand National Institute of Emergency Medicine; 2013. https://www.niems.go.th/1/Ebook/Detail/272?group=21. Accessed July 16, 2020.Google Scholar
Lee, JS, Jeon, WC, Ahn, JH, et al. The effect of a cellular-phone video demonstration to improve the quality of dispatcher-assisted chest compression-only cardiopulmonary resuscitation as compared with audio coaching. Resuscitation. 2011;82(1):64–68.CrossRefGoogle ScholarPubMed
Navarro-Patón, R, Freire-Tellado, M, Pavón-Prieto, MDP, et al. Dispatcher assisted CPR: is it still important to continue teaching lay bystander CPR? Am J Emerg Med. 2017;35(4):569–573.CrossRefGoogle ScholarPubMed
Hwang, BN, Lee, EH, Park, HA, et al. Effects of positive dispatcher encouragement on the maintenance of bystander cardiopulmonary resuscitation quality. Medicine. 2020;99(42):e22728.CrossRefGoogle ScholarPubMed
Spelten, O, Warnecke, T, Wetsch, WA, et al. Dispatcher-assisted compression-only cardiopulmonary resuscitation provides best quality cardiopulmonary resuscitation by laypersons: a randomized controlled single-blinded manikin trial. Eur J Anaesthesiol. 2016;33(8):575–580.CrossRefGoogle ScholarPubMed
World Health Organization. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:1–253.Google Scholar
Kleinman, ME, Brennan, EE, Goldberger, ZD, et al. Part 5: adult basic life support and cardiopulmonary resuscitation quality: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 suppl 2):S414–435.CrossRefGoogle ScholarPubMed
Wissenberg, M, Lippert, FK, Folke, F, et al. Association of national initiatives to improve cardiac arrest management with rates of bystander intervention and patient survival after out-of-hospital cardiac arrest. JAMA. 2013;310(13):1377–1384.CrossRefGoogle ScholarPubMed
Ong, ME, Shin, SD, De Souza, NN, et al. Outcomes for out-of-hospital cardiac arrests across 7 countries in Asia: the Pan Asian Resuscitation Outcomes Study (PAROS). Resuscitation. 2015;96:100–108.CrossRefGoogle Scholar
Bohn, A, Weber, TP, Wecker, S, et al. The addition of voice prompts to audiovisual feedback and debriefing does not modify CPR quality or outcomes in out of hospital cardiac arrest—a prospective, randomized trial. Resuscitation. 2011;82(3):257–262.CrossRefGoogle ScholarPubMed
Kramer-Johansen, J, Myklebust, H, Wik, L, et al. Quality of out-of-hospital cardiopulmonary resuscitation with real time automated feedback: a prospective interventional study. Resuscitation. 2006;71(3):283–292.CrossRefGoogle ScholarPubMed
Stiell, IG, Brown, SP, Nichol, G, et al. What is the optimal chest compression depth during out-of-hospital cardiac arrest resuscitation of adult patients? Circulation. 2014;130(22):1962–1970.CrossRefGoogle ScholarPubMed
Vadeboncoeur, T, Stolz, U, Panchal, A, et al. Chest compression depth and survival in out-of-hospital cardiac arrest. Resuscitation. 2014;85(2):182–188.CrossRefGoogle ScholarPubMed
Hallstrom, AP, Cobb, LA, Johnson, E, et al. Dispatcher assisted CPR: implementation and potential benefit. A 12-year study. Resuscitation. 2003;57(2):123–129.CrossRefGoogle ScholarPubMed
Bobrow, BJ, Spaite, DW, Vadeboncoeur, TF, et al. Implementation of a regional telephone cardiopulmonary resuscitation program and outcomes after out-of-hospital cardiac arrest. JAMA Cardiol. 2016;1(3):294–302.CrossRefGoogle ScholarPubMed
Nikolaou, N, Dainty, KN, Couper, K, et al. A systematic review and meta-analysis of the effect of dispatcher-assisted CPR on outcomes from sudden cardiac arrest in adults and children. Resuscitation. 2019;138:82–105.CrossRefGoogle ScholarPubMed
Cheung, S, Deakin, CD, Hsu, R, et al. A prospective manikin-based observational study of telephone-directed cardiopulmonary resuscitation. Resuscitation. 2007;72(3):425–435.CrossRefGoogle ScholarPubMed
Bohm, K, Vaillancourt, C, Charette, ML, et al. In patients with out-of-hospital cardiac arrest, does the provision of dispatch cardiopulmonary resuscitation instructions as opposed to no instructions improve outcome: a systematic review of the literature. Resuscitation. 2011;82(12):1490–1495.CrossRefGoogle ScholarPubMed
Stipulante, S, Tubes, R, El Fassi, M, et al. Implementation of the ALERT algorithm, a new dispatcher-assisted telephone cardiopulmonary resuscitation protocol, in non-Advanced Medical Priority Dispatch System (AMPDS) Emergency Medical Services Centers. Resuscitation. 2014;85(2):177–181.CrossRefGoogle Scholar
Lewis, M, Stubbs, BA, Eisenberg, MS. Dispatcher-assisted cardiopulmonary resuscitation: time to identify cardiac arrest and deliver chest compression instructions. Circulation. 2013;128(14):1522–1530.CrossRefGoogle ScholarPubMed
Park, HJ, Jeong, WJ, Moon, HJ, et al. Factors associated with high-quality cardiopulmonary resuscitation performed by bystander. Emerg Med Int. 2020;2020:8356201.CrossRefGoogle ScholarPubMed
Ghuysen, A, Collas, D, Stipulante, S, et al. Dispatcher-assisted telephone cardiopulmonary resuscitation using a French-language compression-only protocol in volunteers with or without prior life support training: a randomized trial. Resuscitation. 2011;82(1):57–63.CrossRefGoogle ScholarPubMed
Mirza, M, Brown, TB, Saini, D, et al. Instructions to “push as hard as you can” improve average chest compression depth in dispatcher-assisted cardiopulmonary resuscitation. Resuscitation. 2008;79(1):97–102.CrossRefGoogle Scholar
Plata, C, Nowack, M, Loeser, J, et al. Verbal motivation vs. digital real-time feedback during cardiopulmonary resuscitation: comparing bystander CPR quality in a randomized and controlled manikin study of simulated cardiac arrest. Prehosp Emerg Care. 2021;25(3):377–387.CrossRefGoogle Scholar
Kellermann, AL, Hackman, BB, Somes, G. Dispatcher-assisted cardiopulmonary resuscitation. Validation of efficacy. Circulation. 1989;80(5):1231–1239.CrossRefGoogle Scholar
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