Purpose of the study
Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) significantly increases rates of bystander cardiopulmonary resuscitation, which improves patient’s outcome (1). In addition to DA-CPR the European Resuscitation Council recommends establishing community first responder (CFR) systems (2). CFRs can improve patient survival by providing rapid high-quality CPR (3). This study attempted to compare CPR-performance between dispatcher-assisted untrained bystanders and CFRs.
Materials and methods
In a prospective study 41 out-of-hospital cardiac arrest scenarios were simulated as part of the project MV|LIFE|DRONE-Pilot (ethical approval BB124/19). In each scenario an untrained bystander (no first aid course in the last 5 years) started DA-CPR. After 2 -4 minutes a CFR arrived and continued CPR. CFR were trained persons with medical background, who volunteer to attend cardiac arrests within their close vicinity. They were alerted by smartphone. During the study bystanders (n=41) participated only once while CFRs (n=22) participated in several scenarios. Resuscitation parameters were assessed with the manikin Resusci Anne (Laerdal®).
Results
There were no significant differences between the two groups regarding gender and age. Mean frequency of chest compressions (bystanders 99 bpm [91 – 106 bpm], CFR 109 bpm [102 – 118 bpm], p<0.001) and correct hand position (bystander 88%, CFR 98%, p=0.048) differed significantly between bystanders and CFRs. Complete chest release was performed by 67% of bystanders and by 73% of CFRs (p=0.632). There was no significant difference in compression depth between bystanders (50.90 mm [47 - 59 mm]) and CFRs (51.94 mm [46 - 58 mm]) (p=0.575).
Conclusions
Although bystanders received instructions by a dispatcher, resuscitation quality was not as high as CFRs`. In addition to expanding DA-CPR, schemes, that dispatch trained volunteers to cardiac arrests, should be promoted.
(1) 10.1016/j.resuscitation.2019.02.035
(2) 10.1016/j.resuscitation.2021.02.008
(3) 10.1161/JAHA.117.005873

Systems saving lives in rural Germany – Performance of cardiopulmonary resuscitation by dispatcher assisted untrained bystanders compared to community first responders

Implementation of the Guidelines - How do we put the new ERC Guidelines into practice?

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