Ann Emerg Med. 1991 Apr;20(4):362-6. doi: 10.1016/s0196-0644(05)81655-5.

Dispatcher-assisted telephone CPR: common delays and time standards for delivery.

Annals of emergency medicine

L L Culley, J J Clark, M S Eisenberg, M P Larsen

PMID: 2003662 DOI: 10.1016/s0196-0644(05)81655-5

Abstract

STUDY OBJECTIVES: To determine the rate of bystander CPR before and after implementation of a telephone CPR program in King County; to determine the reasons for dispatcher delays in identifying patients in cardiac arrest in delivering CPR instructions over the telephone; and to suggest time standards for delivery of the telephone CPR message.

DESIGN: An ongoing cardiac arrest surveillance system to calculate the annual bystander CPR rates from 1976 through 1988. Two hundred sixty-seven taped recordings of calls reporting cardiac arrests to nine emergency dispatch centers during 1988 were reviewed and timed.

SETTING: King County, Washington, excluding the city of Seattle.

PARTICIPANTS: Two hundred sixty-seven persons with out-of-hospital cardiac arrests receiving emergency medical services. Arrests in doctors' offices, clinics, or nursing homes were excluded.

INTERVENTIONS: Dispatcher-assisted telephone CPR.

MEASUREMENTS AND MAIN RESULTS: The rate of bystander CPR increased from 32% (1976 through 1981) to 54% (1982 through 1988) after implementation of the dispatcher-assisted telephone CPR program, although an increase in survival could not be demonstrated. The median time for dispatchers to identify the problem was 75 seconds; to deliver the early protocols, 19 seconds; to deliver the ventilation instructions, 25 seconds; and to deliver compression instructions, 30 seconds. The total time to deliver the entire CPR message was 2.3 minutes. The most frequent cause for delay was unnecessary questions (57%) with questions about patient age asked most frequently (32%). Other causes included the caller not being near the patient (29%) and deviations from protocol (22%).

CONCLUSION: In a metropolitan emergency medical services system, a dispatcher-assisted telephone CPR program was associated with an increase in bystander CPR. Delays in proper delivery of telephone CPR can be minimized through training.

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MeSH terms

• Emergency Medical Service Communication Systems* / standards
• Heart Arrest / therapy
• Humans
• Resuscitation* / methods
• Resuscitation* / statistics & numerical data
• Telephone*
• Time Factors

Publication Types

• Journal Article