Evaluation of telephone CPR advice for adult cardiac arrest patients

SummaryIntroductionTelephone cardiopulmonary resuscitation (CPR) advice aims to increase the quality and quantity of bystander CPR, one of the few interventions shown to improve outcome in cardiac arrest. We evaluated a current telephone protocol (based on 2000 ILCOR guidelines) to assess the effectiveness of verbal CPR instructions.MethodsEmergency calls were identified from AMPDS codes for cardiac arrest and checked against the ambulance patient record form to confirm the diagnosis. Calls over a seven month period were analysed retrospectively, and the time taken to perform interventions calculated.Results176 calls were analysed; of those 145 (82.4%) were confirmed cases of cardiac arrest. CPR was already underway in 11 cases (7.5%), 101 callers (69.7%) agreed to attempt CPR with telephone instructions. The median time to open the airway was 128 s (62–482 s), to perform the first ventilation was 247 s (80–633 s), and to perform the first chest compression was 315 s (153–750 s). Of those attempting CPR, 21 (20.8%) stopped because they were unable to move the patient onto a hard surface, and 28 (27.7%) required multiple attempts to perform effective ventilations. In the telephone CPR group 42/101 (40.6%) did not receive any chest compressions before the arrival of the ambulance crew.ConclusionsAlthough current telephone-CPR instructions significantly improve the numbers of patients in whom bystander CPR is attempted, significant delays and poor quality CPR are likely to limit any benefits.