Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 11, 119228, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 11, 119228, Singapore.
Resuscitation. 2019 May;138:153-159. doi: 10.1016/j.resuscitation.2019.03.003. Epub 2019 Mar 12.
The introduction of dispatcher assistance (DA) services has led to increased bystander cardiopulmonary resuscitation (CPR) participation rates. However, the extent to which DA improves CPR quality remains unclear. This study aimed to evaluate the efficacy of DA in improving CPR quality among healthcare professionals and laypersons within a multi-ethnic Southeast Asian population.
A parallel, randomised controlled, open label trial was performed. Four hundred and twelve participants were recruited via convenience sampling in a public location. In a simulated cardiac-arrest scenario, the participants were randomised to perform CPR with DA over the phone (DA+) or CPR without DA (DA-). The ratio of participant assignment to DA+ and DA- was 1:1. The primary outcomes were CPR compression depth, compression rate, no-flow time, complete release of pressure between compressions, and hand location. The assessment involved CPR manikins and human assessors.
A larger proportion of participants in DA + achieved the correct compression rate (34.3% vs 18.1%, p < 0.001). There was no difference in the other primary outcomes. A subgroup analysis revealed that healthcare professionals in DA+ had a higher proportion of correct hand location compared to those in DA- (82.1% vs. 53.5%, p < 0.05). There was no significant difference in CPR quality among laypersons with valid CPR certification regardless of whether they received DA.
DA should be provided to laypersons without valid CPR certification, as well as healthcare professionals. The identification of gaps in the current DA protocol highlights areas where specific changes can be made to improve CPR quality.
调度员协助（DA）服务的引入导致旁观者心肺复苏（CPR）参与率增加。然而，DA 提高 CPR 质量的程度仍不清楚。本研究旨在评估 DA 在提高多族裔东南亚人群中医疗保健专业人员和非专业人员 CPR 质量方面的效果。
进行了一项平行、随机对照、开放性标签试验。通过在公共场所进行方便抽样，共招募了 412 名参与者。在模拟心脏骤停情况下，参与者随机接受电话中的 DA 指导下的 CPR（DA+）或无 DA 指导的 CPR（DA-）。参与者分配给 DA+和 DA-的比例为 1:1。主要结局是 CPR 压缩深度、压缩率、无血流时间、完全释放压力之间的完全释放和手的位置。评估涉及 CPR 模型和人工评估员。
更多的 DA+参与者达到了正确的压缩率（34.3% vs 18.1%，p<0.001）。其他主要结局没有差异。亚组分析显示，DA+中的医疗保健专业人员的正确手位置比例高于 DA-中的手位置比例（82.1% vs. 53.5%，p<0.05）。无论是否接受 DA，有有效 CPR 认证的非专业人员的 CPR 质量没有显著差异。
应该向没有有效 CPR 认证的非专业人员以及医疗保健专业人员提供 DA。确定当前 DA 协议中的差距突出了可以进行具体更改以提高 CPR 质量的领域。
