Effect of bystander CPR initiation prior to the emergency call on ROSC and 30day survival: An evaluation of 548 emergency calls

TY - JOUR

T1 - Effect of bystander CPR initiation prior to the emergency call on ROSC and 30day survival

T2 - An evaluation of 548 emergency calls

AU - Viereck, Søren

AU - Palsgaard Møller, Thea

AU - Kjær Ersbøll, Annette

AU - Folke, Fredrik

AU - Lippert, Freddy

N1 - Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

PY - 2017/2/1

Y1 - 2017/2/1

N2 - BACKGROUND: This study aimed at evaluating if time for initiation of bystander cardiopulmonary resuscitation (CPR) - prior to the emergency call (CPRprior) versus during the emergency call following dispatcher-assisted CPR (CPRduring) - was associated with return of spontaneous circulation (ROSC) and 30-day survival. The secondary aim was to identify predictors of CPRprior.METHODS: This observational study evaluated out-of-hospital cardiac arrests (OHCA) occurring in the Capital Region of Denmark from 01.01.2013 to 31.12.2013. OHCAs were linked to emergency medical dispatch centre records and corresponding emergency calls were evaluated. Multivariable logistic regression analyses were applied to evaluate the association between time for initiation of bystander CPR, ROSC, and 30-day survival. Univariable logistic regression analyses were applied to identify predictors of CPRprior.RESULTS: The study included 548 emergency calls for OHCA patients receiving bystander CPR, 34.9% (n=191) in the CPRpriorgroup and 65.1% (n=357) in the CPRduringgroup. Multivariable analyses showed no difference in ROSC (OR=0.88, 95% CI: 0.56-1.38) or 30-day survival (OR=1.14, 95% CI: 0.68-1.92) between CPRpriorand CPRduring. Predictors positively associated with CPRpriorincluded witnessed OHCA and healthcare professional bystanders. Predictors negatively associated with CPRpriorincluded residential location, solitary bystanders, and bystanders related to the patient.CONCLUSIONS: The majority of bystander CPR (65%) was initiated during the emergency call, following dispatcher-assisted CPR instructions. Whether bystander CPR was initiated prior to emergency call versus during the emergency call following dispatcher-assisted CPR was not associated with ROSC or 30-day survival. Dispatcher-assisted CPR was especially beneficial for the initiation of bystander CPR in residential areas.

AB - BACKGROUND: This study aimed at evaluating if time for initiation of bystander cardiopulmonary resuscitation (CPR) - prior to the emergency call (CPRprior) versus during the emergency call following dispatcher-assisted CPR (CPRduring) - was associated with return of spontaneous circulation (ROSC) and 30-day survival. The secondary aim was to identify predictors of CPRprior.METHODS: This observational study evaluated out-of-hospital cardiac arrests (OHCA) occurring in the Capital Region of Denmark from 01.01.2013 to 31.12.2013. OHCAs were linked to emergency medical dispatch centre records and corresponding emergency calls were evaluated. Multivariable logistic regression analyses were applied to evaluate the association between time for initiation of bystander CPR, ROSC, and 30-day survival. Univariable logistic regression analyses were applied to identify predictors of CPRprior.RESULTS: The study included 548 emergency calls for OHCA patients receiving bystander CPR, 34.9% (n=191) in the CPRpriorgroup and 65.1% (n=357) in the CPRduringgroup. Multivariable analyses showed no difference in ROSC (OR=0.88, 95% CI: 0.56-1.38) or 30-day survival (OR=1.14, 95% CI: 0.68-1.92) between CPRpriorand CPRduring. Predictors positively associated with CPRpriorincluded witnessed OHCA and healthcare professional bystanders. Predictors negatively associated with CPRpriorincluded residential location, solitary bystanders, and bystanders related to the patient.CONCLUSIONS: The majority of bystander CPR (65%) was initiated during the emergency call, following dispatcher-assisted CPR instructions. Whether bystander CPR was initiated prior to emergency call versus during the emergency call following dispatcher-assisted CPR was not associated with ROSC or 30-day survival. Dispatcher-assisted CPR was especially beneficial for the initiation of bystander CPR in residential areas.

KW - Aged

KW - Cardiopulmonary Resuscitation

KW - Denmark

KW - Emergency Medical Services

KW - Female

KW - Humans

KW - Logistic Models

KW - Male

KW - Multivariate Analysis

KW - Out-of-Hospital Cardiac Arrest/mortality

U2 - 10.1016/j.resuscitation.2016.11.020

DO - 10.1016/j.resuscitation.2016.11.020

M3 - Journal article

C2 - 27923114

SN - 0300-9572

VL - 111

SP - 55

EP - 61

JO - Resuscitation

JF - Resuscitation

ER -