Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Prehosp Disaster Med. 2021 Dec;36(6):702-707. doi: 10.1017/S1049023X21001084. Epub 2021 Oct 14.
Out-of-hospital cardiac arrest (OHCA) is a life-threatening condition with an overall survival rate that generally does not exceed 10%. Several factors play essential roles in increasing survival among patients experiencing cardiac arrest outside the hospital. Previous studies have reported that implementing a dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) program increases bystander CPR, quality of chest compressions, and patient survival. This study aimed to assess the effectiveness of a DA-CPR program developed by the Thailand National Institute for Emergency Medicine (NIEMS).
This was an experimental study using a manikin model. The participants comprised both health care providers and non-health care providers aged 18 to 60 years. They were randomly assigned to either the DA-CPR group or the uninstructed CPR (U-CPR) group and performed chest compressions on a manikin model for two minutes. The sequentially numbered, opaque, sealed envelope method was used for randomization in blocks of four with a ratio of 1:1.
There were 100 participants in this study (49 in the DA-CPR group and 51 in the U-CPR group). Time to initiate chest compressions was statistically significantly longer in the DA-CPR group than in the U-CPR group (85.82 [SD = 32.54] seconds versus 23.94 [SD = 16.70] seconds; P <.001). However, the CPR instruction did not translate into better performance or quality of chest compressions for the overall sample or for health care or non-health care providers.
Those in the CPR-trained group applied chest compressions (initiated CPR) more quickly than those who initiated CPR based upon dispatch-based CPR instructions.
院外心脏骤停(OHCA)是一种危及生命的病症,总体存活率通常不超过 10%。有几个因素在提高院外发生心脏骤停患者的存活率方面起着至关重要的作用。先前的研究报告称,实施调度员协助心肺复苏术(DA-CPR)计划可以增加旁观者 CPR、胸外按压的质量,并提高患者的生存率。本研究旨在评估泰国国家紧急医学研究所(NIEMS)开发的 DA-CPR 计划的有效性。
这是一项使用模拟人模型的实验研究。参与者包括年龄在 18 至 60 岁之间的医疗保健提供者和非医疗保健提供者。他们被随机分配到 DA-CPR 组或未接受指导的 CPR(U-CPR)组,并在模拟人模型上进行两分钟的胸外按压。使用顺序编号、不透明、密封信封的方法进行随机分组,每组 4 个,比例为 1:1。
本研究共有 100 名参与者(DA-CPR 组 49 名,U-CPR 组 51 名)。DA-CPR 组开始胸外按压的时间明显长于 U-CPR 组(85.82 [SD=32.54] 秒比 23.94 [SD=16.70] 秒;P<.001)。然而,CPR 指导并没有转化为整体样本或医疗保健或非医疗保健提供者更好的胸外按压表现或质量。
接受过 CPR 培训的组比根据调度员指导启动 CPR 的组更快地进行胸外按压(启动 CPR)。