Increasing bystander CPR: potential of a one question telecommunicator identification algorithm

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Thomas Rea²  Eddie Markul³  Cleo Subido²  Jenny Shin²  Randi Riesenberg²  Ross Orpet¹ 

[1] From the University of Washington, Seattle, USA;Emergency Medical Services Division of Public Health – Seattle & King County, ᅟ, ᅟ;University of Illinois at Chicago, Chicago, USA

关键词: Dispatcher;    Diagnosis;    Cardiopulmonary Resuscitation (CPR);    Cardiac arrest;   

Others  :  1181839
DOI  :  10.1186/s13049-015-0115-1

 received in 2014-11-03, accepted in 2015-04-09,  发布年份 2015

【 摘 要 】

Objectives

Telecommunicators use a two-question algorithm to identify cardiac arrest: Is the individual conscious? Is the individual breathing normally? Although this approach increases arrest identification and consequently bystander CPR, the strategy does not identify all arrests and requires time to complete. We evaluated the implications of a one-question strategy that inquired only about consciousness.

Methods

We undertook a 3-month observational study of consecutive cases identified as unconscious by the telecommunicator prior to EMS arrival who were not receiving bystander CPR. We evaluated the extent that a one-question strategy could increase arrest identification and reduce the identification interval; and the trade-off whereby additional persons without arrest could potentially receive CPR.

Results

Among 679 eligible cases, 20% (n = 135) were in arrest and 80% (n = 544) were not in arrest. The two-question algorithm identified 90% (121/135) as true arrest. Of the 135 in arrest, 70% (n = 95) received compressions. The median interval from call to arrest identification was 72 seconds, with a median of 14 seconds for the breathing normally question. Using the two-question algorithm, telecommunicators incorrectly classified 30% (n = 164/544) of non-arrests as arrest. Bystanders proceeded to compressions in 16% (n = 85/544) of persons not in arrest. A one-question approach that inquired only about consciousness could potentially increase the arrest identification by 10% (14/135) and reduce the interval to compressions by a median of 14 seconds; however the strategy would potentially triple the number of non-arrest cases (544 versus 164) eligible for CPR instructions.

Conclusion

A single-question arrest identification algorithm may not achieve a favorable balance of risk and benefit.

【 授权许可】

   
2015 Orpet et al.; licensee BioMed Central.

【 图 表 】

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