Bystander Dispatcher-Assisted CPR Recommended in Possible Cardiac Arrest

A new study recommends that emergency medical service (EMS) dispatchers should assertively provide cardiopulmonary resuscitation (CPR) instructions to bystanders who suspect someone is having a heart attack.

Researchers at the University of Washington (UW, Seattle, USA) studied data from 1,700 adult patients treated by bystanders that received CPR instructions from dispatchers in King County (WA, USA) between June 2004 and January 2007. Of these, 55% (938) were in actually in cardiac arrest, and 45% (762) were not. Of the patients who received CPR who were not actually in cardiac arrest, 46% progressed to chest compressions with further instructions from a dispatcher; CPR for the others was discontinued, possibly because the patient regained consciousness or started breathing normally before chest compressions began.

Researchers then analyzed the hospital charts of 247 of the nonarrest patients that received dispatcher-assisted chest compressions and then transported to the hospital, and identified those that had suffered discomfort or injuries resulting from CPR; in all, 9% reported discomfort, including soreness and tenderness of the chest; and 2% (four patients) suffered fractures, three due to chest compressions and one from moving the patient from the bed to the floor in preparation for CPR. The researchers concluded that the benefits from recommending CPR for someone who needs it greatly outweigh the risks from recommending CPR for someone who does not. The study was published in the January 5, 2010, issue of Circulation.

"We know that early CPR from a bystander improves survival, and from our study, poses only a minimal risk of injury when guided by dispatchers,” said lead author Thomas Rea, M.D., M.P.H., of WU, who also serves as medical director of the King County Medic One (Kent, WA, USA) EMS division. "So it seems reasonable to continue challenging communities nationwide to increase bystander CPR through assertive dispatch programs.”

Related Links:
University of Washington
King County Medic One