Emergency Medical Services Dispatch Center, State of Vaud, Lausanne, Switzerland.
Acad Emerg Med. 2010 Sep;17(9):1012-5. doi: 10.1111/j.1553-2712.2010.00851.x.
The aim of this study was to evaluate the rate and reason for refusal of telephone-based cardiopulmonary resuscitation (CPR) instruction by bystanders after the implementation of the dispatch center's systematic telephone CPR protocol.
Over a 15-month period the authors prospectively collected all case records from the emergency medical services (EMS) dispatch center when CPR had been proposed to the bystander calling in and recorded the reason for declining or not performing that the bystander spontaneously mentioned. All pediatric and adult traumatic and nontraumatic cases were included. Situations when resuscitation had been spontaneously initiated by bystanders were excluded.
During the study period, dispatchers proposed CPR on 264 occasions: 232 adult nontraumatic cases, 17 adult traumatic cases, and 15 pediatric (traumatic and nontraumatic) cases. The proposal was accepted in 163 cases (61.7%, 95% confidence interval [CI] = 54.6% to 66.5%), and CPR was eventually performed in 134 cases (51%, 95% CI = 43.2% to 55.3%). In 35 of the cases where resuscitation was not carried out, the condition of the patient or conditions at the scene made this decision medically appropriate. Of the remaining 95 cases, 55 were due to physical limitations of the caller, and 33 were due to emotional distress.
The telephone CPR acceptance rate of 62% in this study is comparable to those of other similar studies. Because bystanders' physical condition is one of the keys to success, the rate may not improve as the population ages.
本研究旨在评估实施调度中心系统电话心肺复苏（CPR）协议后，旁观者拒绝接受电话基础 CPR 指导的比率及其原因。
在 15 个月的时间里，作者前瞻性地从急救医疗服务（EMS）调度中心收集了所有 CPR 被提议给来电者的案例记录，并记录了旁观者自发提及的拒绝或不执行该操作的原因。所有儿科和成人创伤性和非创伤性病例均包括在内。旁观者自发开始复苏的情况除外。
在研究期间，调度员共提出 264 次 CPR 建议：232 例成人非创伤性病例、17 例成人创伤性病例和 15 例儿科（创伤性和非创伤性）病例。有 163 例（61.7%，95%置信区间 [CI] = 54.6%至 66.5%）接受了建议，最终有 134 例（51%，95% CI = 43.2%至 55.3%）进行了 CPR。在未进行复苏的 35 例病例中，患者的病情或现场情况使该决定在医学上是合理的。在其余 95 例病例中，55 例是由于来电者的身体限制，33 例是由于情绪困扰。
本研究中电话 CPR 的接受率为 62%，与其他类似研究相当。由于旁观者的身体状况是成功的关键之一，因此随着人口老龄化，该比率可能不会提高。
