1. Dispatcher-assisted conventional cardiopulmonary resuscitation and outcomes for paediatric out-of-hospital cardiac arrests
- Author
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Yumiko Goto, Akira Funada, Tetsuo Maeda, and Yoshikazu Goto
- Subjects
Cardiovascular event ,medicine.medical_specialty ,Emergency Medical Services ,medicine.medical_treatment ,education ,Emergency Nursing ,health services administration ,Medicine ,Bystander cardiopulmonary resuscitation ,Humans ,cardiovascular diseases ,Cardiopulmonary resuscitation ,Registries ,Child ,Propensity Score ,health care economics and organizations ,Retrospective Studies ,Out of hospital ,business.industry ,Basic life support ,Retrospective cohort study ,Cardiopulmonary Resuscitation ,Emergency medicine ,Propensity score matching ,Emergency Medicine ,Bystander cpr ,Cardiology and Cardiovascular Medicine ,business ,therapeutics ,Out-of-Hospital Cardiac Arrest - Abstract
As asphyxial cardiac arrest is more common than cardiac arrest from a primary cardiac event in paediatric cardiac arrest, effective ventilation is important during paediatric cardiopulmonary resuscitation (CPR). We aimed to determine optimal dispatcher-assisted CPR instructions for bystanders after paediatric out-of-hospital cardiac arrest (OHCA).We analysed the records of 8172 children who received bystander dispatcher-assisted CPR. Data were obtained from an All-Japan Utstein-style registry from 2005 to 2017. Patients were divided into conventional CPR and compression-only CPR groups. The primary study endpoint was 1-month neurologically intact survival, defined as a Cerebral Performance Category score of 1 or 2 (CPC 1-2).The 1-month CPC 1-2 rate was significantly higher in the dispatcher-assisted conventional CPR group than in the dispatcher-assisted compression-only CPR group (before propensity score matching, 5.7% [175/3077] vs. 3.1% [160/5095], p 0.0001, adjusted odds ratio 2.48, 95% confidence interval 1.19-3.22; after propensity score matching, 6.0% [156/2618] vs. 2.6% [69/2618], p 0.0001, adjusted odds ratio 2.42, 95% confidence interval 1.76-3.32). In most subgroup analyses after matching, dispatcher-assisted conventional CPR had a higher CPC 1-2 rate than dispatcher-assisted compression-only CPR; however, CPC 1-2 rates were similar between the two groups for patients with an initial shockable rhythm, those with total prehospital CPR time ≥ 20 min, those receiving public access defibrillation, advanced airway management, or adrenaline administration.Within the limitations of this retrospective observational study, dispatcher-assisted conventional CPR was preferable to dispatcher-assisted compression-only CPR as optimal CPR instructions for coaching callers to perform bystander CPR.
- Published
- 2021