“Early recognition and call for help” and “early bystander cardiopulmonary resuscitation
(CPR)” are both substantiated critical components in the chain of survival following
out-of-hospital cardiac arrest (OHCA).
1
,
2
However, the incidence of immediate bystander CPR before emergency medical service
(EMS) arrival remains low.
3
One option for increasing bystander CPR and post−OHCA survival is dispatcher-assisted
(DA-CPR) or telephone CPR.
4
,
5
,
- Panchal A.R.
- Berg K.M.
- Cabañas J.G.
- et al.
2019 American Heart Association Focused Update on Systems of Care: dispatcher-assisted
cardiopulmonary resuscitation and cardiac arrest centers: an update to the American
Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular
Care.
Circulation. 2019; 140https://doi.org/10.1161/CIR.0000000000000733
6
Provision of DA-CPR increases bystander CPR rate and is associated with improved
survival.
- Duff J.P.
- Topjian A.A.
- Berg M.D.
- et al.
2019 American Heart Association Focused Update on Pediatric Advanced Life Support:
an update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation
and Emergency Cardiovascular Care.
Circulation. 2019; 140https://doi.org/10.1161/CIR.0000000000000736
5
,
- Panchal A.R.
- Berg K.M.
- Cabañas J.G.
- et al.
2019 American Heart Association Focused Update on Systems of Care: dispatcher-assisted
cardiopulmonary resuscitation and cardiac arrest centers: an update to the American
Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular
Care.
Circulation. 2019; 140https://doi.org/10.1161/CIR.0000000000000733
6
,
- Duff J.P.
- Topjian A.A.
- Berg M.D.
- et al.
2019 American Heart Association Focused Update on Pediatric Advanced Life Support:
an update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation
and Emergency Cardiovascular Care.
Circulation. 2019; 140https://doi.org/10.1161/CIR.0000000000000736
7
,
8
Successful recognition of OHCA during an emergency call is an essential prerequisite
for providing DA-CPR.
8
,
9
However, early recognition of OHCA using emergency medical (EM) dispatchers can be
challenging. As approximately 1% of all emergency calls will actually be an OHCA,
10
the International Liaison Committee on Resuscitation, the European Resuscitation
Council, and the American Heart Association (AHA) made a strong recommendation in
their guidelines that dispatchers should determine whether a patient is unconscious
with abnormal breathing to ensure effective DA-CPR.
11
,
12
,
13
However, the presence of abnormal breathing (i.e. gasping or agonal breathing) is
a relatively under-appreciated diagnostic element of cardiac arrest. Although approximately
50% of patients with cardiac arrest demonstrate agonal breathing, dispatchers find
it difficult to interpret breathing patterns during an emergency call.
14
Therefore, EM dispatchers make every effort to recognize OHCA by evaluating some
heterogeneous words and phrases or symptoms and/or using scripted protocols.
8
,
9
,
15
In this issue of Resuscitation, Derkenne et al.
16
reported a very unique method called the “Hand on Belly (HoB)” to detect OHCA from
a caller over the phone, devised by the Paris Fire Fighters Dispatch Centre in 2011
and first evaluated in 2014.
17
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Telephone CPR (T-CPR) American Heart Association recommendations & performance measures. Accessed 17 November 2019 at https://cpr.heart.org/en/resuscitation-science/telephone-cpr/t-cpr-recommendations-and-performance-measures.
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Article info
Publication history
Published online: December 07, 2019
Publication stage
In Press Journal Pre-ProofIdentification
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© 2019 Elsevier B.V. All rights reserved.
