| Summary: | A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. === Abstract
Background: Bystander cardiopulmonary resuscitation (CPR) improves out-of-hospital cardiac arrest (OHCA) survival. Telephone CPR (TCPR) comprises CPR instruction given by emergency dispatchers to bystanders responding to OHCA and the CPR performed as a result. TCPR instructions improve bystander CPR rates, but the quality of the instructions varies widely. No standardized system exists to critically evaluate the TCPR intervention.
Methods: Investigators developed a novel, standardized system to analyze audio recordings of suspected OHCA calls from a large regional 9-1-1 dispatch center. As the initial step of a TCPR quality improvement initiative, baseline data were obtained from October 2010 to November 2011. Dispatcher recognition of CPR need, delivery of TCPR instructions, and bystander CPR performance were documented.
Results: A total of 590 calls were analyzed. CPR was indicated in 317 calls and already in progress in 94. Dispatchers recognized the need for TCPR in 176 of the 223 (79%) remaining calls. CPR instructions were started in 65/223 (29%) and bystander CPR resulting from TCPR instructions was started in 31/223 (14%). Median time intervals were: recognition of CPR need [69s (IQR: 44, 104.5)], initiation of CPR instructions [175s (IQR: 139, 207)], and first chest compression [251s (IQR: 189, 306)].
Conclusion: It is feasible to employ a simple data collection and reporting system for critical evaluation of the TCPR intervention. A standardized methodology for measuring TCPR is necessary to perform on-going quality improvement, to establish performance standards, and for future research on how to optimize bystander CPR rates and OHCA survival.
|
|---|
