Document Detail


Time to First Compression Using Medical Priority Dispatch System Compression-First Dispatcher-Assisted Cardiopulmonary Resuscitation Protocols.
MedLine Citation:
PMID:  22150694     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Introduction. Without bystander cardiopulmonary resuscitation (CPR), cardiac arrest survival decreases 7%-10% for every minute of delay until defibrillation. Dispatcher-assisted CPR (D-CPR) has been shown to increase the rates of bystander CPR and cardiac arrest survival. Other reports suggest that the most critical component of bystander CPR is chest compressions with minimal interruption. Beginning with version 11.2 of the Medical Priority Dispatch System (MPDS) protocols, instructions for mouth-to-mouth ventilation (MTMV) and pulse check were removed and a compression-first pathway was introduced to facilitate rapid delivery of compressions. Additionally, unconscious choking and third-trimester pregnancy decision-making criteria were added in versions 11.3 and 12.0, respectively. However, the effects of these changes on time to first compression (TTFC) have not been evaluated. Objective. We sought to quantify the TTFC of MPDS versions 11.2, 11.3, and 12.0 for all calls identified as cardiac arrest on call intake that did not require MTMV instruction. Methods. Audio recordings of all D-CPR events for October 2005 through May 2010 were analyzed for TTFC. Differences in TTFC across versions were compared using the Kruskal-Wallis test. Results. A total of 778 cases received D-CPR. Of these, 259 were excluded because they met criteria for MTMV (pediatric patients, allergic reaction, etc.), were missing data, or were not initially identified as cardiac arrest. Of the remaining 519 calls, the mean TTFC was 240 seconds, with no significant variation across the MPDS versions (p = 0.08). Conclusions. Following the removal of instructions for pulse check and MTMV, as well as other minor changes in the MPDS protocols, we found the overall TTFC to be 240 seconds with little variation across the three versions evaluated. This represents an improvement in TTFC compared with reports of an earlier version of MPDS that included pulse checks and MTMV instructions (315 seconds). However, the MPDS TTFC does not compare favorably with reports of older, non-MPDS protocols that included pulse checks and MTMV. Efforts should continue to focus on improving this key, and modifiable, determinant of cardiac arrest survival. Key words: emergency medical dispatch; emergency medical services; prehospital; paramedic; cardiac arrest; CPR.
Authors:
Lee M Van Vleet; Michael W Hubble
Related Documents :
21335884 - Applications of tactile feedback in medicine.
21335804 - Practical methods for designing medical training simulators.
25226204 - Negative impact of self-stigmatization on attitude toward medication adherence in patie...
25215034 - Post-disaster medical rescue strategy in tropical regions.
24656324 - Human identification through the patella-report of two cases.
9567734 - A comparison of the efficacy of stimulus control for medicated and nonmedicated insomni...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-12
Journal Detail:
Title:  Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors     Volume:  -     ISSN:  1545-0066     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9703530     Medline TA:  Prehosp Emerg Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From Wake County EMS (LVV) , Raleigh, North Carolina ; and the Emergency Medical Care Program, Western Carolina University (MWH) , Cullowhee, North Carolina .
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Management of chronic spontaneous urticaria in real life - in accordance with the guidelines? A cros...
Next Document:  Pontomedullary Lacerations in Falls from a Height-A Retrospective Autopsy Study*