Federal Public Health Services, Liege, Belgium.
Department of Public Health, University of Liege, Belgium.
Resuscitation. 2014 Feb;85(2):177-81. doi: 10.1016/j.resuscitation.2013.10.005. Epub 2013 Oct 18.
Early bystander cardiopulmonary resuscitation (CPR) is a key factor in improving survival from out-of-hospital cardiac arrest (OHCA). The ALERT (Algorithme Liégeois d'Encadrement à la Réanimation par Téléphone) algorithm has the potential to help bystanders initiate CPR. This study evaluates the effectiveness of the implementation of this protocol in a non-Advanced Medical Priority Dispatch System area.
We designed a before and after study based on a 3-month retrospective assessment of victims of OHCA in 2009, before the implementation of the ALERT protocol in Liege emergency medical communication centre (EMCC), and the prospective evaluation of the same 3 months in 2011, immediately after the implementation.
At the moment of the call, dispatchers were able to identify 233 OHCA in the first period and 235 in the second. Victims were predominantly male (59%, both periods), with mean ages of 64.1 and 63.9 years, respectively. In 2009, only 9.9% victims benefited from bystander CPR, this increased to 22.5% in 2011 (p<0.0002). The main reasons for protocol under-utilisation were: assistance not offered by the dispatcher (42.3%), caller physically remote from the victim (20.6%). Median time from call to first compression, defined here as no flow time, was 253s in 2009 and 168s in 2011 (NS). Ten victims were admitted to hospital after ROSC in 2009 and 13 in 2011 (p=0.09).
From the beginning and despite its under-utilisation, the ALERT protocol significantly improved the number of patients in whom bystander CPR was attempted.
早期旁观者心肺复苏（CPR）是提高院外心脏骤停（OHCA）患者生存率的关键因素。ALERT（Liège 电话复苏指导算法）算法有可能帮助旁观者开始进行 CPR。本研究评估了在非高级医疗优先调度系统区域实施该方案的效果。
我们设计了一项前后对照研究，基于 2009 年在列日紧急医疗通讯中心（EMCC）实施 ALERT 方案之前对 OHCA 患者进行的 3 个月回顾性评估，以及实施后立即对同一 3 个月的前瞻性评估。
在呼叫时，调度员能够在第一期识别出 233 例 OHCA，第二期识别出 235 例。受害者主要为男性（59%，两个时期），平均年龄分别为 64.1 岁和 63.9 岁。2009 年，仅有 9.9%的受害者接受了旁观者 CPR，而 2011 年这一比例增加到 22.5%（p<0.0002）。协议利用率低的主要原因是：调度员未提供援助（42.3%），呼叫者与受害者身体距离较远（20.6%）。这里定义的无血流时间，即从呼叫到第一次按压的中位数时间，在 2009 年为 253 秒，在 2011 年为 168 秒（无统计学意义）。2009 年有 10 例患者在恢复自主循环后被送入医院，2011 年有 13 例（p=0.09）。
从一开始，尽管利用率不高，ALERT 方案显著增加了尝试旁观者 CPR 的患者数量。
