Telephone-assisted CPR

Abstract

Despite numerous efforts, out-of-hospital cardiac arrest (OHCA) survivalhas not significantly increased in recent decades. The firsttelephone-assisted cardiopulmonary resuscitation (T-CPR) studies werepublished in the 1980s, but only in the last decade has TaEuroCPR beenimplemented in dispatch centers. TaEuroCPR is still not available in alldispatch centers and no national or international TaEuroCPRrecommendations are available.Studies from PubMed were identified and evaluated. Preliminaryinformation from the European Dispatch Center Survey (EDiCeS) is alsoincluded.In all, 42 studies were included. TaEuroCPR is implemented in 87.6 % ofthose dispatch centers which have joined the not-yet published EDiCeS.According to German Resuscitation Registry data, about 10 % of OHCApatients received TaEuroCPR in 2014. Agonal breathing is the leadingcause for nonrecognition of OHCA by the dispatcher. Sensitivity of OHCArecognition by the dispatcher is about 75 %, whereby 8-45 % of thesepatients were not in cardiac arrest. The time interval from call tofirst compression is 140-328 s. Instructing rescue breathing bytelephone is time consuming, leads to extensive hands-off times, andoften to ineffective ventilation; therefore, rescue breathing is notindicated in adults with primary cardiac arrest. Studies showed improvedsurvival with standardized TaEuroCPR implementation.T-CPR is established in many dispatch centers. However, emergency callinterrogation and TaEuroCPR vary between dispatch centers and are oftenperformed without evaluation. International recommendations withstandardized quality control are necessary and may lead to improvedsurvival.