Abstract
Purpose:
Quality of DAT-CPR instructions between EMT and RN are not well known. In vertical dispatch call-taker and CPR instructor would be the same EMT; in horizontal dispatch call-taker would be EMT while CPR instructor could be RN to takeover the calls of recognized OHCA. This study was to compare the quality of DAT-CPR instructions between EMTs and RNs.
Materials and methods:
This was a one-year observational database prospectively collected from a metropolitan OHCA-DATCPR registry with one centralized dispatch center and EMT as all call-takers. After call-takers recognizing patients as cardiac arrest, they could directly launch DAT-CPR instructions by themselves (iEMT) or transfer calls to RN (iRN) for DAT-CPR instructions. Both of them were well-trained for DATCPR skills. All audio call records eligible for non-traumatic OHCA were assessed by experienced third person afterward. The quality outcomes included: bystander-starting chest compressions (CC), persistent online CPR instruction until ambulance arrival (I-persistence), continual instruction and accompany bystander until compressions handover by paramedics at scene (I-handover), and time periods between recognition, instruction, and CC. The comparisons were adjusted with patient age and sex.
Results:
A total of 1,574 eligible patients and call records were analyzed. Bystander CCs were delivered on 83.8% of patients, no difference between iEMT and iRN (84.4% versus 80.6%, p=0.13). iEMT had higher rates of I-persistence (81.3% versus 69.9%, p<0.01; aOR:1.9 [95% CI 1.4-2.5]) and I-handover (59.8% versus 34.4%, p<0.01; aOR:2.8 [95% CI 2.1-3.8]) than iRN. There was no time difference from initiating instruction till first CC between two groups (iEMT 79.8sec versus iRN 80.6sec, p=0.83). Time from OHCA recognition to CPR instruction was faster while instructors were iEMT (34.2sec versus 47.4sec, p<0.01).
Conclusions:
Well-trained EMTs may perform better DAT-CPR instructions than RNs for persistence and continually until chest compressions handover by paramedic professionals, and shorter time from recognition-to-instruction.

6 - Quality Assessment of Instructions for Dispatcher-Assisted Telephone Cardiopulmonary Resuscitation (DATCPR) Performed Between Emergency Medical Technicians (EMTs) and Registered Nurses (RNs)