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Abstract 16179: A Novel Protocol for Dispatcher Assisted Cardiopulmonary Resuscitation Improves Quality of Cardiopulmonary Resuscitation: A Randomized Controlled Simulation Study


 Introduction:
 Dispatcher assisted CPR (DA-CPR) increases rate and quality of CPR and improves survival. Several studies have shown that changing one element in a dispatcher’s protocol improve CPR performance. Whether one improvement counter the effect of another improvement is unknown and the effect of combining several beneficial elements in a dispatcher protocol remains to be clarified.
 
 
 Hypothesis:
 A novel DA-CPR protocol, combining several single elements improving CPR performance, is superior to a standard DA-CPR protocol.
 
 
 Methods:
 Based on previous research and pilot studies a novel DA-CPR protocol including new wording on chest compression depth and hand position, the use of a metronome, provision of encouragements and introducing a 10-sec rest per minute was developed. Subsequently, laypersons were randomized to perform chest compression-only DA-CPR on a manikin with either the novel DA-CPR protocol or a standard DA-CPR protocol. Data on CPR quality was collected on video recordings and from the manikin and evaluated by two assessors blinded to the experimental groups. The primary outcome was a composite endpoint of time to first compression, hand position, compression depth and -rate and hands-off time, which were rated separately each minute and merged into an overall score (max 22 points).
 
 
 Results:
 128 laypersons were included in the study. The novel protocol (n=61, three were excluded) significantly improved the CPR quality compared to the standard protocol (n=64) (mean (SD)): 18.6 (1.4) points vs. 17.5 (1.7) points, p<0.001. The novel protocol resulted in significantly deeper (mean (SD): 58 (12) mm vs. 52 (13) mm, p=0.02) and faster (mean (SD): 114 (11) min-1 vs. 110 (13) min-1, p=0.04) compressions when compared to the standard protocol. The novel protocol resulted in shorter time to first compression (median (IQR): 65 (59, 70) sec vs. 72 (66, 81) sec, p<0.001) and better hand position for compressions (61% vs. 36%, p=0.01) compared to the standard protocol. As intended, hands-off time per minute was prolonged with the novel protocol (median (IQR): 6 (5, 7) sec vs. 0 (0, 1) sec).
 
 
 Conclusions:
 In a simulated cardiac arrest scenario, a novel protocol for DA-CPR was superior to a standard DA-CPR protocol. Both protocols resulted in high quality CPR.
