The effect of telephone advice on cardiopulmonary resuscitation (CPR) on the rate of bystander CPR in out-of-hospital cardiopulmonary arrest in a typical urban area

Abstract

Introduction: The frequency of telephone advice for cardiopulmonary resuscitation (T-CPR) and its effect are unclear. We have few data concerning how many persons who are willing to perform CPR under the setting of the T-CPR system. Most of these data were from action reports in the pre-hospital EMS records. Methods: This study was a population-based observational case series of out-of-hospital cardiopulmonary arrest (OHCPA). The primary outcome was the acceptability of a bystander to perform CPR according to T-CPR. In our emergency department, one medical doctor interviewed the bystanders regarding T-CPR and CPR; this doctor was devoted to obtaining information from the patients. Results: Of the 803 patients in, T-CPR advice was provided in 47% and CPR was actually performed in 47% independent of T-CPR guidance. Of the 373 cases in which lay persons received T-CPR, 95% provided CPR. Dispatchers could more easily provide T-CPR to family members compared with friends and passengers. Twenty-one percent of callers made emergency calls after consulting with others (indirect call). In non-traumatic victims who underwent bystander CPR, 43% experienced the return of spontaneous circulation, and 5% were discharged with a mild disorder or no neurological abnormality. Conclusions: We conclude that 95% of bystanders are willing to perform CPR under the T-CPR system, but we cannot conclude that bystander CPR may not affect the survival rate. These findings indicate that bystanders should be guided with T-CPR.