DISPATCHERS’ IMPRESSIONS AND ACTUAL QUALITY OF CPR DURING TELEPHONE-ASSISTED BYSTANDER CPR: A POOLED ANALYSIS OF 94 SIMULATED, MANIKIN-BASED CPR SCENARIOS

Resumen

Background:

The quality of telephone-assisted cardiopulmonary resuscitation (CPR) needs improvement. This study investigates whether dispatchers’ perception is an adequate measure of the actual quality of CPR provided by laypersons.

Methods:

Individual participant data from three randomized simulation trials, with identical methodology but different interventions were combined for this analysis. Professional dispatchers gave telephone assistance to laypersons, who each provided 10 minutes CPR on a standard resuscitation manikin. Based on their impression during the telephone call the remotely located dispatchers were requested to classify the quality of providers’ CPR as adequate or inadequate. Based on actual readings from manikins we classified providers' performance as adequate at 5-6 cm for depth and 100-120 cpm for rate. We calculated metrics of diagnostic test accuracy with design adjusted confidence intervals (CI).

Results:

Six experienced dispatchers rated the performance of 94 laypersons (female: n=38 (43%), age 37 ±14). In 905 analyzed minutes of telephone CPR, the mean compression depth and rate was 41 ±13 millimeters and 98 ±24 compressions per minute, respectively. Dispatchers’ diagnostic test accuracy for adequate compression depth yielded a sensitivity of 65% (95%CI 36-95) and specificity of 42% (95%CI 32-53). For adequate compression rate sensitivity was 75% (95%CI 64-86) and specificity was 42% (95%CI 32-52). Explanatory analyses revealed that female dispatchers tended to overestimate laypersons' performance whereas male dispatchers’ underestimate the performance of female laypersons.

Conclusion:

The ability of dispatchers to estimate the quality of telephone-assisted CPR is limited.

MeSH Keywords:   cardiopulmonary resuscitation, out of hospital cardiac arrest, chest compression, manikin, and telephone