Changes to DA-CPR instructions: Can we reduce time to first compression and improve quality of bystander CPR?

Ian Painter, Devora Eisenberg Chavez, Brooke R. Ike, Mei Po Yip, Shin-Ping Tu, Steven M. Bradley, Thomas D. Rea, Hendrika Meischke

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Introduction: 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. Methods: 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. Results: 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 24. s (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. Discussion: 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.

Original languageEnglish (US)
Pages (from-to)1169-1173
Number of pages5
JournalResuscitation
Volume85
Issue number9
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Cardiopulmonary Resuscitation
Heart Arrest
Manikins
Thorax
Hand
Randomized Controlled Trials
Quality of Life

Keywords

  • Chest compressions
  • Dispatch-assisted instructions
  • Simulation
  • Time-delay

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

Cite this

Changes to DA-CPR instructions : Can we reduce time to first compression and improve quality of bystander CPR? / Painter, Ian; Chavez, Devora Eisenberg; Ike, Brooke R.; Yip, Mei Po; Tu, Shin-Ping; Bradley, Steven M.; Rea, Thomas D.; Meischke, Hendrika.

In: Resuscitation, Vol. 85, No. 9, 01.01.2014, p. 1169-1173.

Research output: Contribution to journalArticle

Painter, Ian ; Chavez, Devora Eisenberg ; Ike, Brooke R. ; Yip, Mei Po ; Tu, Shin-Ping ; Bradley, Steven M. ; Rea, Thomas D. ; Meischke, Hendrika. / Changes to DA-CPR instructions : Can we reduce time to first compression and improve quality of bystander CPR?. In: Resuscitation. 2014 ; Vol. 85, No. 9. pp. 1169-1173.
@article{2ed005643f9b44fc905bc133b95e6760,
title = "Changes to DA-CPR instructions: Can we reduce time to first compression and improve quality of bystander CPR?",
abstract = "Introduction: 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. Methods: 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. Results: 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 24. s (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. Discussion: 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.",
keywords = "Chest compressions, Dispatch-assisted instructions, Simulation, Time-delay",
author = "Ian Painter and Chavez, {Devora Eisenberg} and Ike, {Brooke R.} and Yip, {Mei Po} and Shin-Ping Tu and Bradley, {Steven M.} and Rea, {Thomas D.} and Hendrika Meischke",
year = "2014",
month = "1",
day = "1",
doi = "10.1016/j.resuscitation.2014.05.015",
language = "English (US)",
volume = "85",
pages = "1169--1173",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd",
number = "9",

}

TY - JOUR

T1 - Changes to DA-CPR instructions

T2 - Can we reduce time to first compression and improve quality of bystander CPR?

AU - Painter, Ian

AU - Chavez, Devora Eisenberg

AU - Ike, Brooke R.

AU - Yip, Mei Po

AU - Tu, Shin-Ping

AU - Bradley, Steven M.

AU - Rea, Thomas D.

AU - Meischke, Hendrika

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Introduction: 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. Methods: 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. Results: 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 24. s (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. Discussion: 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.

AB - Introduction: 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. Methods: 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. Results: 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 24. s (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. Discussion: 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.

KW - Chest compressions

KW - Dispatch-assisted instructions

KW - Simulation

KW - Time-delay

UR - http://www.scopus.com/inward/record.url?scp=84906055138&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84906055138&partnerID=8YFLogxK

U2 - 10.1016/j.resuscitation.2014.05.015

DO - 10.1016/j.resuscitation.2014.05.015

M3 - Article

C2 - 24864063

AN - SCOPUS:84906055138

VL - 85

SP - 1169

EP - 1173

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

IS - 9

ER -