Karolinska Institutet, Department of Clinical Science and Education and Section of Emergency Medicine, Södersjukhuset, 118 83 Stockholm, Sweden.
Resuscitation. 2011 Dec;82(12):1490-5. doi: 10.1016/j.resuscitation.2011.09.004. Epub 2011 Sep 16.
Early bystander cardiopulmonary resuscitation (CPR) provides an essential bridge to successful defibrillation from sudden cardiac arrest (SCA) and there is a need to increase the prevalence and quality of bystander CPR. Emergency medical dispatchers can give CPR instructions to a bystander calling for an ambulance enabling even an inexperienced bystander to start CPR. The impact of these instructions has not been evaluated.
To determine if, in adult and pediatric patients with out-of-hospital cardiac arrest, the provision of dispatch CPR instructions as opposed to no instructions improves outcome.
Two independent reviewers used standardized forms and procedures to review papers published between January, 1985 and December, 2009. Findings were peer-reviewed by the International Liaison Committee on Resuscitation.
We identified 665 citations; five met the inclusion criteria. One retrospective cohort study reported improved survival with dispatch CPR instructions than without it. Three studies, two observational and one with retrospective controls showed trends toward increased survival after dispatcher-assisted CPR was implemented and one showed trend toward decreased survival. There were no randomised studies addressing the topic. No studies addressing dispatch CPR instructions in the pediatric population were found.
There is limited evidence supporting the survival benefit of dispatch-assisted CPR instructions. All studies comparing survival outcomes when CPR is provided with or without the assistance of dispatch-assisted CPR instructions lack the statistical power to draw significant conclusions. Since it has been demonstrated that such instructions can improve bystander CPR rates, it is reasonable to recommend they should be provided to all callers reporting a victim in cardiac arrest.
早期旁观者心肺复苏（CPR）为成功除颤提供了至关重要的桥梁，以从心脏骤停（SCA）中恢复过来，因此需要提高旁观者 CPR 的普及度和质量。紧急医疗调度员可以向呼叫救护车的旁观者提供 CPR 指导，使即使是没有经验的旁观者也能开始进行 CPR。这些指导的影响尚未得到评估。
确定在院外心脏骤停的成年和儿科患者中，与不提供指导相比，提供调度员 CPR 指导是否能改善结果。
两名独立审查员使用标准化表格和程序，对 1985 年 1 月至 2009 年 12 月期间发表的论文进行了回顾。国际复苏联络委员会对研究结果进行了同行评审。
我们共检索到 665 篇参考文献；其中 5 篇符合纳入标准。一项回顾性队列研究报告称，与没有指导相比，提供调度员 CPR 指导可提高生存率。三项研究，两项观察性研究和一项具有回顾性对照的研究表明，在实施调度员协助 CPR 后，生存率有增加的趋势，而一项研究则显示生存率有降低的趋势。没有随机研究涉及该主题。未发现涉及调度员 CPR 指导在儿科人群中应用的研究。
目前有有限的证据支持调度协助 CPR 指导可带来生存获益。所有比较提供与不提供调度协助 CPR 指导时生存率的研究均缺乏得出显著结论的统计学效力。由于已经证明这些指导可以提高旁观者 CPR 率，因此合理的建议是向报告心脏骤停受害者的所有呼叫者提供此类指导。
