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Review
. 2025 Aug 11.
doi: 10.1007/s11739-025-03991-7. Online ahead of print.

Experiences, challenges, and best practices of dispatcher-assisted cardiopulmonary resuscitation: a scoping review

Guglielmo Imbriaco  1   2 , Alessandro Galazzi  3 , Federico Semeraro  4 , Nicola Ramacciati  5
Affiliations
Review

Experiences, challenges, and best practices of dispatcher-assisted cardiopulmonary resuscitation: a scoping review

Guglielmo Imbriaco et al. Intern Emerg Med. .

Abstract

Background: Out-of-hospital cardiac arrest is a leading cause of mortality, with survival rates from 8 to 13%. Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) may increase bystander-initiated CPR, improving survival outcomes. Despite these benefits, DA-CPR is often hindered by barriers and organizational issues.

Objective: To map and summarize the existing literature on DA-CPR, to identify strategies to improve provision rates, overcoming potential barriers.

Eligibility criteria: Primary studies with an English abstract, published between 2018 and 2024, focusing on experiences, challenges, and best practices related to DA-CPR. Studies were included if they reported on emergency callers and dispatchers (population), focusing on DA-CPR provision methods (concept), in any setting (context). Simulation studies were excluded.

Sources of evidence: The following databases were searched: Medline (PubMed), EMBASE, CINAHL, and the Cochrane Library. Grey literature from repositories, conference proceedings, and social media were also reviewed.

Charting methods: Characteristics of the included studies were reported in a specific extraction table and synthesized narratively.

Results: Fifty-eight studies were included. Results were categorized into themes (dispatcher, caller, system, and community/context). Dispatcher training, simplified protocols, effective communication, and video calls emerged as elements potentially improving DA-CPR provision. Caller-related barriers like emotional distress and language problems were prevalent. System-level interventions, including centralized call-handling and performance evaluations, improved DA-CPR rates. Community initiatives for CPR education enhanced bystander compliance.

Conclusions: This scoping review identifies strategies to enhance DA-CPR provision, emphasizing tailored dispatcher protocols, communication strategies, system-level improvements, and community-based interventions. Future research should evaluate the effectiveness of these strategies to optimize out-of-hospital cardiac arrest response.

Keywords: Dispatcher-assisted cardiopulmonary resuscitation; Emergency medical communication centre; Out-of-hospital cardiac arrest; Scoping review; Telephone CPR.

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Conflict of interest statement

Declarations. Conflict of interest: GI is a member of the Scientific Committee of the Italian Resuscitation Council (IRC) and the board of the Italian Association of Critical Care Nurses (Aniarti). FS is the Chair of the European Resuscitation Council (ERC), Emeritus member of the ILCOR BLS Working Group and member of IRC Foundation. AG and NR have no competing interests. Ethical approval: As this scoping review is based on the analysis of previously published literature, ethical approval was not required. Authorship statement: All authors made a significant contribution to the conception, study design, data collection, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published and agreed to be accountable for all aspects of the work.

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