A before-after interventional trial of dispatcher-assisted cardio-pulmonary resuscitation for out-of-hospital cardiac arrests in Singapore

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• 作者：Sumitro Harjanto^a ; May Xue Bi Na^b ; Ying Hao^c ; Yih Yng Ng^d ; Nausheen Doctor^e ; E. Shaun Goh^f ; Benjamin Sieu-Hon Leong^g ; Han Nee Gan^h ; Michael Yih Chong Chiaⁱ ; Lai Peng Tham^j ; Si Oon Cheah^k ; Nur Shahidah^e ; Marcus Eng Hock Ong^e ; ^l ; ^{marcus.ong.e.h@sgh.com.sg" class="auth_mail" title="E-mail the corresponding author} ; For the PAROS study group
• 关键词：Dispatcher-assisted ; Cardiopulmonary resuscitation ; Survival ; Cardiac arrest
• 刊名：Resuscitation
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：102
• 期：Complete
• 页码：85-93
• 全文大小：507 K

文摘

To evaluate the effects of a comprehensive dispatcher-assisted CPR (DACPR) training program on bystander CPR (BCPR) rate and the outcomes of out-of-hospital cardiac arrest (OHCA) in Singapore.

Methods

This is an initial program evaluation of a national DACPR intervention. A before–after analysis was conducted using OHCA cases retrieved from a local registry and DACPR information derived from audio recordings and ambulance notes. The primary outcomes were survival to admission, survival at 30 days post-arrest and good functional recovery.

Results

Data was collected before the intervention (April 2010 to December 2011), during the run-in period (January 2012 to June 2012) and after the intervention (July 2012 to February 2013). A total of 2968 cases were included in the study with a mean age of 65.6. Overall survival rate was 3.9% (116) with good functional recovery in 2.2% (66) of the patients. BCPR rate increased from 22.4% to 42.1% (p < 0.001) with odds ratio (OR) of 2.52 (95% confidence interval [CI]: 2.09–3.04) and ROSC increased significantly from 26.5% to 31.2% (p = 0.02) with OR of 1.26 (95%CI: 1.04–1.53) after the intervention. Significantly higher survival at 30 days was observed for patients who received BCPR from a trained person as compared to no BCPR (p = 0.001, OR = 2.07 [95%CI: 1.41–3.02]) and DACPR (p = 0.04, OR = 0.30 [95%CI: 0.04–2.18]).

Conclusion

A significant increase in BCPR and ROSC was observed after the intervention. There was a trend to suggest improved survival outcomes with the intervention pending further results from the trial.