Cardiopulmonary resuscitation (CPR), even though given over-the-phone, can still save lives, a new report has revealed.
Researchers from the University of Arizona (UA) Department of Emergency Medicine found that doing the Telephone Cardiopulmonary Resuscitation (TCPR) program can significantly improve rates of survival and prognostic outcomes of patients who have suffered cardiac emergencies.
UA Colleges of Medicine professor and co-director of the Arizona Emergency Medicine Research Center Dr. Bentley Bobrow said CPR is a lifesaver for out-of-hospital cardiac arrest (OHCA) but it should be performed sooner so patients can survive and have better prognosis. Unfortunately, majority of cardiac arrest patients don't get CPR before rescuers arrive at the scene.
OHCA survival rates will improve by as much as twice to thrice when bystander intervention (BCPR) is performed. However, less than half of OHCA patients receive BCPR despite availability of CPR training for the public.
The Institute of Medicine, together with the American Heart Association (AHA), have said that emergency dispatchers and telecommunicators who receive calls of possible cardiac arrests must be able to immediately identify and assist those without CPR training to perform BCPR to increase survival.
For their study, the researchers investigated 2,334 over-the-phone recordings from 911 calls and correlated them with response from emergency medical services (EMS) and hospital survival rate data.
They found that executing a bundle of care composed of TCPR training, special guideline-based protocol, and improving quality of care reduced time of initial chest compression by a bystander from 256 seconds to 212 seconds. This raised TCPR rates from 44 percent to 53 percent. Survival outcome and early hospital discharge were also improved from 9 percent to 12 percent. An improvement from 5.6 percent to 8.3 percent was also noted in functional outcomes of OHCA patients who were given TCPR.
Existing TCPR training is not doing much help for OHCA patients because it is not implemented in their most effective way, said Bobrow, who is the medical director of the Arizona Department of Health Services' Bureau of Emergency Medicine Services and Trauma System. TCPR intervention instruction should be improved and continually monitored to make sure it delivers maximum impact, he added.
Bobrow also said TCPR implementation would only focus on improving what is already available. For instance, dispatchers must be able to identify, over the phone, if the patient is having a cardiac arrest. It would also be beneficial if people know the symptoms of a cardiac arrest.
"I think it's important for people to know that if they see someone collapse and that person is in obvious distress, to immediately begin chest compressions and have a dispatcher guide them through CPR," said Bobrow.
The research findings were published in JAMA Cardiology on May 4.
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