Experiences, challenges, and best practices of dispatcher-assisted cardiopulmonary resuscitation: a scoping review

Abstract

Background: Out-of-hospital cardiac arrest is a leading cause of mortality, with survival rates from 8 to 13%. Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) may increase bystander-initiated CPR, improving survival outcomes. Despite these benefits, DA-CPR is often hindered by barriers and organizational issues. Objective: To map and summarize the existing literature on DA-CPR, to identify strategies to improve provision rates, overcoming potential barriers. Eligibility criteria: Primary studies with an English abstract, published between 2018 and 2024, focusing on experiences, challenges, and best practices related to DA-CPR. Studies were included if they reported on emergency callers and dispatchers (population), focusing on DA-CPR provision methods (concept), in any setting (context). Simulation studies were excluded. Sources of evidence: The following databases were searched: Medline (PubMed), EMBASE, CINAHL, and the Cochrane Library. Grey literature from repositories, conference proceedings, and social media were also reviewed. Charting methods: Characteristics of the included studies were reported in a specific extraction table and synthesized narratively. Results: Fifty-eight studies were included. Results were categorized into themes (dispatcher, caller, system, and community/context). Dispatcher training, simplified protocols, effective communication, and video calls emerged as elements potentially improving DA-CPR provision. Caller-related barriers like emotional distress and language problems were prevalent. System-level interventions, including centralized call-handling and performance evaluations, improved DA-CPR rates. Community initiatives for CPR education enhanced bystander compliance. Conclusions: This scoping review identifies strategies to enhance DA-CPR provision, emphasizing tailored dispatcher protocols, communication strategies, system-level improvements, and community-based interventions. Future research should evaluate the effectiveness of these strategies to optimize out-of-hospital cardiac arrest response.