BARRIERS TO DISPATCHER-ASSISTED CARDIOPULMONARY RESUSCITATION IN SINGAPORE

Abstract Background Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is effective in increasing bystander CPR in out-of-hospital cardiac arrests (OHCA). Singapore has recently implemented a DA-CPR program. We aimed to characterize barriers to commencement of chest compressions by callers i...

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Published inResuscitation Vol. 105; pp. 149 - 155
Main Authors Ho, Andrew Fu Wah, MBBS, Sim, Zariel Jiaying, Shahidah, Nur, BA, Hao, Ying, PhD, Ng, Yih Yng, MBBS, Leong, Benjamin S.H., MBBS, Zarinah, Siti, Teo, Winston K.L., B.Com, Goh, Geraldine Shu Yi, BSc, Jaafar, Hamizah, Ong, Marcus E.H., MBBS
Format Journal Article
LanguageEnglish
Published Ireland Elsevier B.V 01.08.2016
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Abstract Abstract Background Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is effective in increasing bystander CPR in out-of-hospital cardiac arrests (OHCA). Singapore has recently implemented a DA-CPR program. We aimed to characterize barriers to commencement of chest compressions by callers in Singapore. Methods We analyzed dispatch recordings of OHCA cases received by the ambulance call center between July 2012 and March 2015. Audio recordings of poor quality were excluded. Trained reviewers noted the sequential stages of the dispatcher's recognition of CPR, delivering CPR instructions and caller performing CPR. Time taken to reach these milestones were noted. Barriers to chest compressions were identified. Results A total of 4897 OHCA occurred during the study period, overall bystander CPR rate was 45.7%. 1885 dispatch recordings were reviewed with 1157 cases qualified for dispatcher CPR. In 1128 (97.5%) cases, the dispatcher correctly recognized the need for CPR. CPR instructions were delivered in 1056 (91.3%) cases. Of these, 1007 (87.0%) callers performed CPR to instruction. One or more barriers to chest compressions were identified in 430 (37.2%) cases. The commonest barrier identified was “could not move patient” (27%). Cases where barriers were identified were less likely to have the need for CPR recognized by the dispatcher (94.9% vs 99.0%, p < 0.001), CPR instructions given (79.3% vs 98.3%, p < 0.001) and CPR started (67.9% vs 98.3%, p < 0.001), while the time taken to reach each of these stages were significantly longer (p < 0.001). Conclusion Barriers were present in 37% of cases. They were associated with lower proportion of CPR started and longer delay to CPR.
AbstractList BACKGROUNDDispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is effective in increasing bystander CPR in out-of-hospital cardiac arrests (OHCA). Singapore has recently implemented a DA-CPR program. We aimed to characterize barriers to commencement of chest compressions by callers in Singapore.METHODSWe analyzed dispatch recordings of OHCA cases received by the ambulance call center between July 2012 and March 2015. Audio recordings of poor quality were excluded. Trained reviewers noted the sequential stages of the dispatcher's recognition of CPR, delivering CPR instructions and caller performing CPR. Time taken to reach these milestones was noted. Barriers to chest compressions were identified.RESULTSA total of 4897 OHCA occurred during the study period, overall bystander CPR rate was 45.7%. 1885 dispatch recordings were reviewed with 1157 cases qualified for dispatcher CPR. In 1128 (97.5%) cases, the dispatcher correctly recognized the need for CPR. CPR instructions were delivered in 1056 (91.3%) cases. Of these, 1007 (87.0%) callers performed CPR to instruction. One or more barriers to chest compressions were identified in 430 (37.2%) cases. The commonest barrier identified was "could not move patient" (27%). Cases where barriers were identified were less likely to have the need for CPR recognized by the dispatcher (94.9% vs. 99.0%, p<0.001), CPR instructions given (79.3% vs. 98.3%, p<0.001) and CPR started (67.9% vs. 98.3%, p<0.001), while the time taken to reach each of these stages were significantly longer (p<0.001).CONCLUSIONBarriers were present in 37% of cases. They were associated with lower proportion of CPR started and longer delay to CPR.
Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is effective in increasing bystander CPR in out-of-hospital cardiac arrests (OHCA). Singapore has recently implemented a DA-CPR program. We aimed to characterize barriers to commencement of chest compressions by callers in Singapore. We analyzed dispatch recordings of OHCA cases received by the ambulance call center between July 2012 and March 2015. Audio recordings of poor quality were excluded. Trained reviewers noted the sequential stages of the dispatcher's recognition of CPR, delivering CPR instructions and caller performing CPR. Time taken to reach these milestones was noted. Barriers to chest compressions were identified. A total of 4897 OHCA occurred during the study period, overall bystander CPR rate was 45.7%. 1885 dispatch recordings were reviewed with 1157 cases qualified for dispatcher CPR. In 1128 (97.5%) cases, the dispatcher correctly recognized the need for CPR. CPR instructions were delivered in 1056 (91.3%) cases. Of these, 1007 (87.0%) callers performed CPR to instruction. One or more barriers to chest compressions were identified in 430 (37.2%) cases. The commonest barrier identified was ⿿could not move patient⿿ (27%). Cases where barriers were identified were less likely to have the need for CPR recognized by the dispatcher (94.9% vs. 99.0%, p<0.001), CPR instructions given (79.3% vs. 98.3%, p<0.001) and CPR started (67.9% vs. 98.3%, p<0.001), while the time taken to reach each of these stages were significantly longer (p<0.001). Barriers were present in 37% of cases. They were associated with lower proportion of CPR started and longer delay to CPR.
Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is effective in increasing bystander CPR in out-of-hospital cardiac arrests (OHCA). Singapore has recently implemented a DA-CPR program. We aimed to characterize barriers to commencement of chest compressions by callers in Singapore. We analyzed dispatch recordings of OHCA cases received by the ambulance call center between July 2012 and March 2015. Audio recordings of poor quality were excluded. Trained reviewers noted the sequential stages of the dispatcher's recognition of CPR, delivering CPR instructions and caller performing CPR. Time taken to reach these milestones was noted. Barriers to chest compressions were identified. A total of 4897 OHCA occurred during the study period, overall bystander CPR rate was 45.7%. 1885 dispatch recordings were reviewed with 1157 cases qualified for dispatcher CPR. In 1128 (97.5%) cases, the dispatcher correctly recognized the need for CPR. CPR instructions were delivered in 1056 (91.3%) cases. Of these, 1007 (87.0%) callers performed CPR to instruction. One or more barriers to chest compressions were identified in 430 (37.2%) cases. The commonest barrier identified was "could not move patient" (27%). Cases where barriers were identified were less likely to have the need for CPR recognized by the dispatcher (94.9% vs. 99.0%, p<0.001), CPR instructions given (79.3% vs. 98.3%, p<0.001) and CPR started (67.9% vs. 98.3%, p<0.001), while the time taken to reach each of these stages were significantly longer (p<0.001). Barriers were present in 37% of cases. They were associated with lower proportion of CPR started and longer delay to CPR.
Abstract Background Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is effective in increasing bystander CPR in out-of-hospital cardiac arrests (OHCA). Singapore has recently implemented a DA-CPR program. We aimed to characterize barriers to commencement of chest compressions by callers in Singapore. Methods We analyzed dispatch recordings of OHCA cases received by the ambulance call center between July 2012 and March 2015. Audio recordings of poor quality were excluded. Trained reviewers noted the sequential stages of the dispatcher's recognition of CPR, delivering CPR instructions and caller performing CPR. Time taken to reach these milestones were noted. Barriers to chest compressions were identified. Results A total of 4897 OHCA occurred during the study period, overall bystander CPR rate was 45.7%. 1885 dispatch recordings were reviewed with 1157 cases qualified for dispatcher CPR. In 1128 (97.5%) cases, the dispatcher correctly recognized the need for CPR. CPR instructions were delivered in 1056 (91.3%) cases. Of these, 1007 (87.0%) callers performed CPR to instruction. One or more barriers to chest compressions were identified in 430 (37.2%) cases. The commonest barrier identified was “could not move patient” (27%). Cases where barriers were identified were less likely to have the need for CPR recognized by the dispatcher (94.9% vs 99.0%, p < 0.001), CPR instructions given (79.3% vs 98.3%, p < 0.001) and CPR started (67.9% vs 98.3%, p < 0.001), while the time taken to reach each of these stages were significantly longer (p < 0.001). Conclusion Barriers were present in 37% of cases. They were associated with lower proportion of CPR started and longer delay to CPR.
Author Ho, Andrew Fu Wah, MBBS
Goh, Geraldine Shu Yi, BSc
Hao, Ying, PhD
Ng, Yih Yng, MBBS
Teo, Winston K.L., B.Com
Jaafar, Hamizah
Sim, Zariel Jiaying
Shahidah, Nur, BA
Zarinah, Siti
Ong, Marcus E.H., MBBS
Leong, Benjamin S.H., MBBS
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  fullname: Ng, Yih Yng, MBBS
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  fullname: Leong, Benjamin S.H., MBBS
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  fullname: Teo, Winston K.L., B.Com
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  fullname: Goh, Geraldine Shu Yi, BSc
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/27288652$$D View this record in MEDLINE/PubMed
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Keywords Bystander
Telephone CPR
Cardiopulmonary resuscitation
Dispatcher-assisted
Cardiac arrest
Language English
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Snippet Abstract Background Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is effective in increasing bystander CPR in out-of-hospital cardiac arrests...
Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is effective in increasing bystander CPR in out-of-hospital cardiac arrests (OHCA). Singapore has...
BACKGROUNDDispatcher-assisted cardiopulmonary resuscitation (DA-CPR) is effective in increasing bystander CPR in out-of-hospital cardiac arrests (OHCA)....
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StartPage 149
SubjectTerms Bystander
Cardiac arrest
Cardiopulmonary resuscitation
Cardiopulmonary Resuscitation - education
Cardiopulmonary Resuscitation - methods
Cardiopulmonary Resuscitation - statistics & numerical data
Dispatcher-assisted
Emergency
Emergency Medical Service Communication Systems - statistics & numerical data
Heart Massage
Humans
Out-of-Hospital Cardiac Arrest - diagnosis
Out-of-Hospital Cardiac Arrest - epidemiology
Out-of-Hospital Cardiac Arrest - therapy
Program Evaluation
Singapore - epidemiology
Telephone CPR
Time-to-Treatment
Title BARRIERS TO DISPATCHER-ASSISTED CARDIOPULMONARY RESUSCITATION IN SINGAPORE
URI https://www.clinicalkey.es/playcontent/1-s2.0-S0300957216300600
https://dx.doi.org/10.1016/j.resuscitation.2016.05.006
https://www.ncbi.nlm.nih.gov/pubmed/27288652
https://search.proquest.com/docview/1807084579
Volume 105
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