After Korea added a nationwide dispatcher-assisted cardiopulmonary resuscitation (CPR) program for out-of-hospital cardiac arrest, rates of bystander CPR nearly doubled, according to the results of a study published online last week in Annals of Emergency Medicine (“Impact of a Dispatcher-Assisted Cardiopulmonary Resuscitation Program and Location of Out-Of-Hospital Cardiac Arrest on Survival and Neurologic Outcome”).
“Bystander CPR is critical to improving notoriously low survival rates for cardiac arrest but many people remain reluctant to provide it, possibly because they lack confidence about doing it properly,” said lead study author Young Sun Ro, MD, DrPH of The Seoul National University Hospital Biomedical Research Institute in Seoul, Korea. “Having a trained dispatcher on the phone talking a bystander through the process while an ambulance gets there made a huge difference in bystander participation. The quality control program for dispatchers helped increase the bystander CPR rate in that short time. In cases where out-of-hospital cardiac arrest occurred in private settings, having dispatcher support was essential to improved neurological outcomes.”
Patients were grouped into three categories: bystander CPR with dispatcher assistance, bystander CPR without dispatcher assistance and no bystander CPR. The total bystander CPR rate increased from 30.9 percent in the first quarter of 2012 to 55.7 percent in the fourth quarter of 2014. Bystander CPR (with or without dispatcher assistance) was more likely to result in higher survival with good neurological recovery (4.8 percent without assistance and 5.2 percent with assistance).
“We really need to reach people at home where two-thirds of out-of-hospital cardiac arrests happen,” said Dr. Ro. “The improvement in participation in public places is encouraging so we need to replicate that success in private settings. Bystanders at home are more likely to be alone, older and female members of the family who need extra support to perform CPR while waiting for professional help to arrive.”