Dispatcher-assisted CPR improves survival from non-traumatic out-of hospital cardiac arrest

Abstracts DISPATCHER-ASSISTED CPR IMPROVES SURVIVAL FROM NON-TRAUMATIC OUT-OF HOSPITAL CARDIAC ARREST Ondrej Franek, Andrlik Michal, Sukupova Petra. Emergency Medical Dispatch, EMS City of Prague, Korunni 98, 101 00 Prague, Czech Republic Purpose of the study: Cardiopulmonary resuscitation (CPR) can improve survival and/or neurological outcome from out-of-hospital cardiac arrest (CA). Dispatcher-assisted CPR (D-CPR) uses dispatchers to assist the caller to perform CPR, and enhance survival. We aimed to assess the effect of D-CPR on survival and neurological outcome after CA in an urban EMS system. Material and methods: All non-traumatic out-of-hospital CA cases in Prague, Czech republic in 2004—2005 were analysed retrospectively and all cases, where the victim was not reported by the caller as ‘‘being conscious’’ in the time of first emergency call were included to the study. The D-CPR was performed by modified protocol with higher compressions: ventilations ratio (100:2) or even by compression-only. Survival to hospital admission and the neurologic outcome as the best achieved cerebral performance category (CPC) within 30 days from admission served as the primary and secondary outcome parameters, respectively. Results: We reviewed 601 cases. DCPR was provided in 266 cases (DCPR+ group), while in 335 cases it was not (DCPR− group). Response times (mean ± S.D.) were 8:09 ± 2:41 in DCPR+ versus 8:01 ± 2:49 min in DCPR−, respectively (p = NS). VF/first rhythm ratio was 0.34 (95% confidence interval (CI), 0.27—0.41) in DCPR+ and 0.35 (95%CI, 0.29—0.41) in DCPR− group, respectively (p = NS). In the DCPR+ group, 108 (38.1%) patients survived to hospital admission; 44 of them (16.5%) survived with CPC5. In DCPR− group, 94 (25.8%) victims survived to hospital admission and 34 (10.1%) achieved favorable neurologic outcome. Survivalto-admission was higher in the DCPR+ group versus DCPR− group (p = 0.007). Also, survival with good neurological outcome (CPC5 versus CPC1-4) was significantly higher in DCPR+ versus DCPR− group (p = 0.027). Conclusions: Both survival-to-admission and survival with good neurological outcome rates were significantly higher in D-CPR+ group. D-CPR appears to be a safe and effective way to increase survival from out-of-hospital CA. References [1] A statement for healthcare professionals from task force of the ILCOR—cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the utstein tem-

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plates for resuscitation registres. Circulation 2004;110:3385—97. Bang A, Biber B, Isaksson L, et al. Evaluation of dispatcher assisted cardiopulmonary resuscitation. Eur J Emerg Med 1999;6:175—83. Kuisma M. et al., Emergency call processing and survival from out-of-hospital ventricular fibrillation. Resuscitation 2005;67(October(1)):89—93. Rea TD, Eisenberg MS, Culley, et al. Dispatcher assisted cardiopulmonary resuscitation and survival in cardiac arrest. Circulation 2001;104:2513—16. Roppolo LP, et al. Modified cardiopulmonary resuscitation (CPR) instruction protocols for emergency medical dispatchers: rationale and recommendations. Resuscitation 2005;65(May):203—10.

doi:10.1016/j.resuscitation.2006.06.064 THE UTSTEIN STYLE REPORTING IN CARDIAC ARREST FOR RESUSCITATED PATIENTS IN THE EMERGENCY DEPARTMENT BETWEEN JANUARY 2001 AND JUNE 2005 Valentin Georgescu, A. Manoleli, I. Dimitriu, L. Dinu, V. Strambu. Emergency Department, ‘‘Saint Pantelimon’’ Clinical Emergency Hospital, Bucharest, Romania Objective: Following the Utstein parameters for in and out of hospital cardiac arrests and the advantages of this kind of reporting style in assessing and improvement of resuscitation quality and data communications. Materials and method: A retrospective analysis of cases of cardiorespiratory arrest admitted between January 2001 and June 2005 in our hospital. Results: From 566 cases out of hospital and in the Emergency Department cardiorespiratory arrest, 195 were developed in the Emergency Department and 10 have had DNAR. ROSC was achieved in 118 cases (63.8%) and 26 (14.1%) patients were discharged alive. From 111 (60%) cases with a presumed cardiac cause, the survival rate was 20.7%, 19.45% were other noncardiac, 9.73% were respiratory causes, 5.4% were secondary to trauma and 5.4% were unknown. First monitored rhythm of 24 patients was shockable (VF/VT), with 54.2% survival rate, compared with 8.1% in non-shockable rhythms. It was noticed an increase of survival rate from 2001 to 2005, such as follows: 2001—–5.4%; 2002—–12.8%; 2003—–14.3%; 2004—–17.8%; 2005—23.8%, due to development of training programs and adoption of Utstein style recommendations. Conclusions: This data collecting system allows a right comparison of cardiopul-