Dispatcher-assisted bystander cardiopulmonary resuscitation in a metropolitan city: A before-after population-based study

Kyoung Jun Song, Sang Do Shin, Chang Bae Park, Joo Yeong Kim, Do Kyun Kim, Chu Hyun Kim, So Young Ha, Marcus Eng Hock Ong, Bentley J Bobrow, Bryan McNally

Research output: Contribution to journalArticle

76 Citations (Scopus)

Abstract

Background: The goal of this study was to determine the effects of dispatcher-assisted bystander cardiopulmonary resuscitation (DA-CPR) on outcomes of out-of-hospital cardiac arrest (OHCA). Methods: All EMS in a metropolitan city with a population of 10 million are dispatched by a single, centralized, and physician-supervised center. Data on patients with adult OHCA with cardiac etiology were collected from the dispatch center registry and from EMS run sheets and hospital medical record review from 2009 to 2011. A standardized DA-CPR protocol (aligned with the 2010 AHA guidelines) we implemented as an intervention in January 2011. The end points were survival to discharge, good neurological outcome, and bystander CPR rate. Multivariate logistic analysis was used to compare between intervention group (2011) and historical control group (2009-2010). Results: Of 8.144 eligible patients, bystander CPR was performed for the patients in 5.7% (148/2600) of cases in 2009, 6.7% (190/2857) in 2010, and 12.4% (334/2686) in 2011 (p < 0.001). The survival to discharge rates was 7.1% (2009), 7.1% (2010), and 9.4% (2011) (p= 0.001). Good neurological outcomes occurred in 2.1% (2009), 2.0% (2010), and 3.6% (2011) of cases (p < 0.001). The adjusted ORs (95% CIs) for survival to discharge compared with 2009 were 1.33 (1.07-1.66) in 2011 and 1.12 (0.89-1.41) in 2010. The adjusted ORs (95% CIs) for good neurological outcomes were 1.67 (1.13-2.45) in 2011 and 1.13 (0.74-1.72) in 2010. Conclusions: An EMS intervention using the DA-CPR protocol was associated with a significant increase in bystander CPR and an improved survival and neurologic outcome after OHCA.

Original languageEnglish (US)
Pages (from-to)34-41
Number of pages8
JournalResuscitation
Volume85
Issue number1
DOIs
StatePublished - Jan 2014

Fingerprint

Cardiopulmonary Resuscitation
Out-of-Hospital Cardiac Arrest
Population
Survival
Hospital Records
Nervous System
Medical Records
Registries
Multivariate Analysis
Guidelines
Physicians
Control Groups

Keywords

  • Bystander
  • Cardiopulmonary resuscitation
  • Heart arrest
  • Outcome

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Emergency
  • Emergency Medicine
  • Medicine(all)

Cite this

Dispatcher-assisted bystander cardiopulmonary resuscitation in a metropolitan city : A before-after population-based study. / Song, Kyoung Jun; Shin, Sang Do; Park, Chang Bae; Kim, Joo Yeong; Kim, Do Kyun; Kim, Chu Hyun; Ha, So Young; Eng Hock Ong, Marcus; Bobrow, Bentley J; McNally, Bryan.

In: Resuscitation, Vol. 85, No. 1, 01.2014, p. 34-41.

Research output: Contribution to journalArticle

Song, KJ, Shin, SD, Park, CB, Kim, JY, Kim, DK, Kim, CH, Ha, SY, Eng Hock Ong, M, Bobrow, BJ & McNally, B 2014, 'Dispatcher-assisted bystander cardiopulmonary resuscitation in a metropolitan city: A before-after population-based study', Resuscitation, vol. 85, no. 1, pp. 34-41. https://doi.org/10.1016/j.resuscitation.2013.06.004
Song, Kyoung Jun ; Shin, Sang Do ; Park, Chang Bae ; Kim, Joo Yeong ; Kim, Do Kyun ; Kim, Chu Hyun ; Ha, So Young ; Eng Hock Ong, Marcus ; Bobrow, Bentley J ; McNally, Bryan. / Dispatcher-assisted bystander cardiopulmonary resuscitation in a metropolitan city : A before-after population-based study. In: Resuscitation. 2014 ; Vol. 85, No. 1. pp. 34-41.
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abstract = "Background: The goal of this study was to determine the effects of dispatcher-assisted bystander cardiopulmonary resuscitation (DA-CPR) on outcomes of out-of-hospital cardiac arrest (OHCA). Methods: All EMS in a metropolitan city with a population of 10 million are dispatched by a single, centralized, and physician-supervised center. Data on patients with adult OHCA with cardiac etiology were collected from the dispatch center registry and from EMS run sheets and hospital medical record review from 2009 to 2011. A standardized DA-CPR protocol (aligned with the 2010 AHA guidelines) we implemented as an intervention in January 2011. The end points were survival to discharge, good neurological outcome, and bystander CPR rate. Multivariate logistic analysis was used to compare between intervention group (2011) and historical control group (2009-2010). Results: Of 8.144 eligible patients, bystander CPR was performed for the patients in 5.7{\%} (148/2600) of cases in 2009, 6.7{\%} (190/2857) in 2010, and 12.4{\%} (334/2686) in 2011 (p < 0.001). The survival to discharge rates was 7.1{\%} (2009), 7.1{\%} (2010), and 9.4{\%} (2011) (p= 0.001). Good neurological outcomes occurred in 2.1{\%} (2009), 2.0{\%} (2010), and 3.6{\%} (2011) of cases (p < 0.001). The adjusted ORs (95{\%} CIs) for survival to discharge compared with 2009 were 1.33 (1.07-1.66) in 2011 and 1.12 (0.89-1.41) in 2010. The adjusted ORs (95{\%} CIs) for good neurological outcomes were 1.67 (1.13-2.45) in 2011 and 1.13 (0.74-1.72) in 2010. Conclusions: An EMS intervention using the DA-CPR protocol was associated with a significant increase in bystander CPR and an improved survival and neurologic outcome after OHCA.",
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T2 - A before-after population-based study

AU - Song, Kyoung Jun

AU - Shin, Sang Do

AU - Park, Chang Bae

AU - Kim, Joo Yeong

AU - Kim, Do Kyun

AU - Kim, Chu Hyun

AU - Ha, So Young

AU - Eng Hock Ong, Marcus

AU - Bobrow, Bentley J

AU - McNally, Bryan

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N2 - Background: The goal of this study was to determine the effects of dispatcher-assisted bystander cardiopulmonary resuscitation (DA-CPR) on outcomes of out-of-hospital cardiac arrest (OHCA). Methods: All EMS in a metropolitan city with a population of 10 million are dispatched by a single, centralized, and physician-supervised center. Data on patients with adult OHCA with cardiac etiology were collected from the dispatch center registry and from EMS run sheets and hospital medical record review from 2009 to 2011. A standardized DA-CPR protocol (aligned with the 2010 AHA guidelines) we implemented as an intervention in January 2011. The end points were survival to discharge, good neurological outcome, and bystander CPR rate. Multivariate logistic analysis was used to compare between intervention group (2011) and historical control group (2009-2010). Results: Of 8.144 eligible patients, bystander CPR was performed for the patients in 5.7% (148/2600) of cases in 2009, 6.7% (190/2857) in 2010, and 12.4% (334/2686) in 2011 (p < 0.001). The survival to discharge rates was 7.1% (2009), 7.1% (2010), and 9.4% (2011) (p= 0.001). Good neurological outcomes occurred in 2.1% (2009), 2.0% (2010), and 3.6% (2011) of cases (p < 0.001). The adjusted ORs (95% CIs) for survival to discharge compared with 2009 were 1.33 (1.07-1.66) in 2011 and 1.12 (0.89-1.41) in 2010. The adjusted ORs (95% CIs) for good neurological outcomes were 1.67 (1.13-2.45) in 2011 and 1.13 (0.74-1.72) in 2010. Conclusions: An EMS intervention using the DA-CPR protocol was associated with a significant increase in bystander CPR and an improved survival and neurologic outcome after OHCA.

AB - Background: The goal of this study was to determine the effects of dispatcher-assisted bystander cardiopulmonary resuscitation (DA-CPR) on outcomes of out-of-hospital cardiac arrest (OHCA). Methods: All EMS in a metropolitan city with a population of 10 million are dispatched by a single, centralized, and physician-supervised center. Data on patients with adult OHCA with cardiac etiology were collected from the dispatch center registry and from EMS run sheets and hospital medical record review from 2009 to 2011. A standardized DA-CPR protocol (aligned with the 2010 AHA guidelines) we implemented as an intervention in January 2011. The end points were survival to discharge, good neurological outcome, and bystander CPR rate. Multivariate logistic analysis was used to compare between intervention group (2011) and historical control group (2009-2010). Results: Of 8.144 eligible patients, bystander CPR was performed for the patients in 5.7% (148/2600) of cases in 2009, 6.7% (190/2857) in 2010, and 12.4% (334/2686) in 2011 (p < 0.001). The survival to discharge rates was 7.1% (2009), 7.1% (2010), and 9.4% (2011) (p= 0.001). Good neurological outcomes occurred in 2.1% (2009), 2.0% (2010), and 3.6% (2011) of cases (p < 0.001). The adjusted ORs (95% CIs) for survival to discharge compared with 2009 were 1.33 (1.07-1.66) in 2011 and 1.12 (0.89-1.41) in 2010. The adjusted ORs (95% CIs) for good neurological outcomes were 1.67 (1.13-2.45) in 2011 and 1.13 (0.74-1.72) in 2010. Conclusions: An EMS intervention using the DA-CPR protocol was associated with a significant increase in bystander CPR and an improved survival and neurologic outcome after OHCA.

KW - Bystander

KW - Cardiopulmonary resuscitation

KW - Heart arrest

KW - Outcome

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