Painter Ian, Chavez Devora Eisenberg, Ike Brooke R, Yip Mei Po, Tu Shin Ping, Bradley Steven M, Rea Thomas D, Meischke Hendrika
Northwest Center for Public Health Practice, School of Public Health, University of Washington, 1107 NE 45th Street, Suite 400, Seattle, WA 98105, USA.
Northwest Center for Public Health Practice, School of Public Health, University of Washington, USA.
Resuscitation. 2014 Sep;85(9):1169-73. doi: 10.1016/j.resuscitation.2014.05.015. Epub 2014 May 23.
Dispatcher-assisted CPR (DA-CPR) can increase rates of bystander CPR, survival, and quality of life following cardiac arrest. Dispatcher protocols designed to improve rapid recognition of arrest and coach CPR may increase survival by (1) reducing preventable time delays to start of chest compressions and (2) improving the quality of bystander CPR.
We conducted a randomized controlled trial comparing a simplified DA CPR script to a conventional DA CPR script in a manikin cardiac arrest simulation with lay participants. The primary outcomes measured were the time interval from call receipt to the first chest compression and the core metrics of chest compression (depth, rate, release, and compression fraction). CPR was measured using a recording manikin for the first 3 min of participant CPR.
Of the 75 participants, 39 were randomized to the simplified instructions and 36 were randomized to the conventional instructions. The interval from call receipt to first compression was 99 s using the simplified script and 124 s using the conventional script for a difference of 24s (p<0.01). Although hand position was judged to be correct more often in the conventional instruction group (88% versus 63%, p<0.01), compression depth was an average 7 mm deeper among those receiving the simplified CPR script (32 mm versus 25 mm, p<0.05). No statistically significant differences were detected between the two instruction groups for compression rate, complete release, number of hands-off periods, or compression fraction.
Simplified DA-CPR instructions to lay callers in simulated cardiac arrest settings resulted in significant reductions in time to first compression and improvements in compression depth. These results suggest an important opportunity to improve DA CPR instructions to reduce delays and improve CPR quality.
调度员辅助心肺复苏（DA-CPR）可提高心脏骤停后旁观者心肺复苏的比例、生存率和生活质量。旨在提高对心脏骤停的快速识别并指导心肺复苏的调度员协议可能通过以下方式提高生存率：（1）减少开始胸外按压的可预防时间延迟；（2）提高旁观者心肺复苏的质量。
我们进行了一项随机对照试验，在模拟人体模型心脏骤停的场景中，让非专业参与者比较简化的DA心肺复苏脚本与传统的DA心肺复苏脚本。测量的主要结果是从接到呼叫到第一次胸外按压的时间间隔以及胸外按压的核心指标（深度、频率、放松和按压比例）。在参与者进行心肺复苏的前3分钟，使用记录人体模型测量心肺复苏情况。
75名参与者中，39人被随机分配到简化指导组，36人被随机分配到传统指导组。使用简化脚本时，从接到呼叫到第一次按压的间隔为99秒，使用传统脚本时为124秒，相差24秒（p<0.01）。尽管传统指导组中手部位置被判定正确的情况更常见（88%对63%，p<0.01），但接受简化心肺复苏脚本的参与者的按压深度平均深7毫米（32毫米对25毫米，p<0.05）。在按压频率、完全放松、手部离开期数量或按压比例方面，两个指导组之间未检测到统计学上的显著差异。
在模拟心脏骤停场景中，向非专业呼叫者提供简化的DA-CPR指导可显著减少首次按压时间并改善按压深度。这些结果表明，有一个重要机会来改进DA心肺复苏指导，以减少延迟并提高心肺复苏质量。
