Universität zu Köln

Spelten, Oliver, Warnecke, Tobias, Wetsch, Wolfgang A., Schier, Robert, Boettiger, Bernd W. and Hinkelbein, Jochen (2016). Dispatcher-assisted compression-only cardiopulmonary resuscitation provides best quality cardiopulmonary resuscitation by laypersons A randomised controlled single-blinded manikin trial. Eur. J. Anaesth., 33 (8). S. 575 - 581. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1365-2346

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Abstract

BACKGROUND High-quality cardiopulmonary resuscitation (CPR) by laypersons is a key determinant of both outcome and survival for out-of-hospital cardiac arrest. Dispatcher-assisted CPR (telephone-CPR, T-CPR) increases the frequency and correctness of bystander-CPR but results in prolonged time to first chest compressions. However, it remains unclear whether instructions for rescue ventilation and/or chest compressions should be recommended for dispatcher-assisted CPR. OBJECTIVE The aim of this study was to evaluate both principles of T-CPR with respect to CPR quality. DESIGN Randomised controlled single-blinded manikin trial. SETTING University Hospital of Cologne, Germany, 1 July 2012 to 30 September 2012. PARTICIPANTS Sixty laypersons between 18 and 65 years. Medically educated individuals, medical professionals and pregnant women were excluded. Participants were asked to resuscitate a manikin and were randomised into three groups: not dispatcher-assisted (uninstructed) CPR (group 1; U-CPR; n = 20), dispatcher-assisted compression-only CPR (group 2; DACO-CPR; n = 19) and full dispatcher-assisted CPR with rescue ventilation (group 3; DAF-CPR; n = 19). MAIN OUTCOME MEASURES Specific parameters of CPR quality [i.e. no-flow-time (NFT) as well as compression and ventilation parameters] were analysed. To compare different groups we used Student's t test and P less than 0.05 was considered significant. RESULTS Initial NFT was lowest in the DACO-CPR group (mean 21.3 +/- 14.4%), followed by dispatcher-assisted full CPR (mean 49.1 +/- 8.5%) and by unassisted CPR (mean 55.0 +/- 12.9%). Initial NFT covering the time of instruction was lower in DACO-CPR (12.1 +/- 5.4%) as compared to dispatcher-assisted full CPR (20.7 +/- 8.1%). Compression depth was similar in all three groups: 40.6 +/- 13.0mm (unassisted CPR), 41.0 +/- 12.2 mm (DACO-CPR) and 38.8 +/- 15.8 mm (dispatcher-assisted full CPR). Average compression frequency was highest in the DACO-CPR group (65.2 +/- 22.4 min(-1)) compared with the unassisted CPR group (35.6 +/- 24.2 min(-1)) and the dispatcher-assisted full CPR group (44.5 +/- 10.8 min(-1)). Correct rescue ventilation was given in 3.1 +/- 11.1% (unassisted CPR) and 1.6 +/- 16.1% (dispatcher-assisted full CPR) of all ventilation attempts. CONCLUSION Best quality of CPR was achieved by DACO-CPR because of superior compression frequencies and reduced NFT. In contrast, the full dispatcher-assisted CPR with a longer initial instructing phase (initial NFT) did not result in enhanced CPR quality or an optimised compression depth.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Spelten, Oliver UNSPECIFIED UNSPECIFIED UNSPECIFIED Warnecke, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Wetsch, Wolfgang A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schier, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Boettiger, Bernd W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hinkelbein, Jochen UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-268800
DOI:	10.1097/EJA.0000000000000432
Journal or Publication Title:	Eur. J. Anaesth.
Volume:	33
Number:	8
Page Range:	S. 575 - 581
Date:	2016
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1365-2346
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HOSPITAL CARDIAC-ARREST; CONTINUOUS CHEST COMPRESSIONS; BASIC LIFE-SUPPORT; COUNCIL GUIDELINES; SURVIVAL; CPR; OUTCOMES; FORCE; MODEL; RATES Multiple languages Anesthesiology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/26880