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. 2022 Sep:178:87-95.
doi: 10.1016/j.resuscitation.2022.07.021. Epub 2022 Jul 21.

Evaluation of telephone-assisted cardiopulmonary resuscitation recommendations for out-of-hospital cardiac arrest

Angel Guerrero  1 , Audrey L Blewer  2 , Anjni P Joiner  3 , Benjamin S H Leong  4 , Nur Shahidah  5 , Pin Pin Pek  6 , Yih Yng Ng  7 , Shalini Arulanandam  8 , Truls Østbye  9 , Alexander Gordee  10 , Maragatha Kuchibhatla  10 , Marcus E H Ong  11
Affiliations

Evaluation of telephone-assisted cardiopulmonary resuscitation recommendations for out-of-hospital cardiac arrest

Angel Guerrero et al. Resuscitation. 2022 Sep.

Abstract

Aim of the study: While out-of-hospital cardiac arrest (OHCA) is associated with poor survival, early bystander CPR (B-CPR) and telephone CPR (T-CPR) improves survival from OHCA. American Heart Association (AHA) Scientific Statements outline recommendations for T-CPR. We assessed these recommendations and hypothesized that meeting performance standards is associated with increased likelihood of survival. Additional variables were analyzed to identify future performance measurements.

Methods: We conducted a retrospective cohort study of non-traumatic, adult, OHCA using the Singapore Pan-Asian Resuscitation Outcomes Study. The primary outcome was likelihood of survival; secondary outcomes were pre-hospital Return of Spontaneous Circulation (ROSC) and B-CPR.

Results: From 2012 to 2016, 2,574 arrests met inclusion criteria. Mean age was 68 ± 15; of 2,574, 1,125 (44%) received T-CPR with 5% (135/2574) survival. T-CPR cases that met the Lerner et al. performance metrics analyzed, demonstrated no statistically significant association with survival. Cases which met the Kurz et al. criteria, "Time for Dispatch to Recognize Need for CPR" and "Time to First Compression," had adjusted odds ratios of survival of 1.01 (95% CI:1.00, 1.02; p = <0.01) and 0.99 (95% CI:0.99, 0.99; p = <0.01), respectively. Identified barriers to CPR decreased the odds of T-CPR and B-CPR being performed. Patients with prehospital ROSC had higher odds of B-CPR being performed. EMS response time < 8 minutes was associated with increased survival among patients receiving T-CPR.

Conclusion: AHA scientific statements on T-CPR programs serve as ideal starting points for increasing the quality of T-CPR systems and patient outcomes. More work is needed to identify other system performance measures.

Keywords: Cardiopulmonary resuscitation; Out-of-hospital cardiac arrest; Telephone CPR.

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Figures

Figure 1.
Figure 1.
Flow chart of patients included in the study. PAROS: Pan-Asian Resuscitation Outcomes Study; OHCA: Out of Hospital Cardiac Arrest; CPR: Cardiopulmonary Resuscitation; T-CPR: Telephone CPR; B-CPR: Bystander CPR
See this image and copyright information in PMC

References

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