Purpose of the study: Early cardiopulmonary resuscitation (CPR) improves survival
in out‑of‑hospital cardiac arrest; dispatcher‑delivered CPR instructions can increase
the number of victims receiving CPR before Emergency Medical Service (EMS) arrival.
However, little is known about the impact of CPR phone instructions on the outcome
of patients (pts) with return of spontaneous circulation (ROSC). The target of this
study is to investigate the impact of phone instructions on short and middle term
mortality, and on neurological outcomes of patients who survived.
Materials and Methods: we enrolled pts admitted to ICU after ROSC following out‑
of‑hospital‑cardiac‑arrest, since 1/1/2008 to 30/06/2016; pts younger than 18, in‑
hospital cardiac‑arrest‑victims, those who underwent cardiac arrest in health
facilities, and missing data records were excluded. Written informed consensus was
obtained for all pts contacted for follow up. Data about comorbility, mortality,
neurologic outcome, CPR timing according to Utstein Style, complications during ICU
stay, metabolic state on ER admission, were collected. Study population was divided
into groups: pts ongoing immediate CPR and those who did not underwent immediate
CPR by laic bystanders; immediate CPR pts were divided into Phone Instructions CPR
and No‑phone instructions CPR. Data were extracted from ICU and EMS databases,
EMS phone calls registration, and processed using STATA software.
Results: 181 pts met study criteria. Laic bystander CPR was given in 55 cases, 30%
of the study population. Phone CPR was given in 9 of these cases (16%) (Results are
summarized in tables 1,2)
26/8/2018 Oxford Abstracts
Early CPR significantly reduced CPR‑free interval. This correlates with a significative
increase in shockable rhythms on EMS arrival. There is a significative reduction in
mortality and disability. The fact that early CPR is delivered by trained laics
bystanders or by Phone‑CPR instructions seems not to affect these findings. Phone‑
CPR is an effective tool to improve survival and disability in ROSC.