Telephone-assisted CPR: A literature review.

Area of Science:

• Emergency medicine
• Public health
• Cardiology

Background:

• Out-of-hospital cardiac arrest (OHCA) survival rates remain stagnant despite decades of effort.
• Telephone-assisted cardiopulmonary resuscitation (T-CPR) has seen increased implementation in dispatch centers over the last decade.
• Current T-CPR availability is inconsistent, lacking national or international standardized recommendations.

Purpose of the Study:

• To evaluate the current status and effectiveness of telephone-assisted cardiopulmonary resuscitation (T-CPR) in out-of-hospital cardiac arrest (OHCA) management.
• To identify challenges and areas for improvement in T-CPR implementation and dispatcher recognition of cardiac arrest.
• To assess the impact of T-CPR on patient survival and advocate for standardized protocols.

Main Methods:

• Systematic literature review of PubMed-identified studies.
• Inclusion of preliminary data from the European Dispatch Center Survey (EDiCeS).
• Analysis of German Resuscitation Registry data for T-CPR utilization and outcomes.

Main Results:

• T-CPR is implemented in 87.6% of dispatch centers surveyed in EDiCeS.
• Dispatcher recognition of OHCA has a sensitivity of approximately 75%, with agonal breathing being a common cause of misidentification.
• Standardized T-CPR implementation demonstrated improved survival rates, despite challenges with rescue breathing instructions and hands-off times.

Conclusions:

• T-CPR is becoming established in dispatch centers, but significant variations in emergency call interrogation and T-CPR procedures exist.
• Lack of standardized protocols and quality control hinders optimal T-CPR effectiveness.
• International recommendations and standardized quality control are crucial for improving OHCA survival through T-CPR.