Study Supports Safety of Dispatcher-Aided CPR
Writing in the latest issue of Circulation, authors from Public Health Seattle–King County’s Emergency Medical Services Division and the University of Washington Department of Medicine report the frequency of serious injury related to dispatcher-assisted bystander CPR among non-arrest patients was low.
A new study published in the American Heart Association's journal Circulation (vol. 121, issue 1, Jan. 5-12, 2010) endorses what the authors call "assertive" dispatcher-assisted CPR performed by bystanders. The authors -- Lindsay White, MPH; Joseph Rogers, MS; Megan Bloomingdale; Carol Fahrenbruch, MSPH; Linda Culley, BA; Cleo Subido, RPL; Mickey Eisenberg, MD, PhD; and Thomas Rea, MD, MPH -– wanted to assess the risk and injury rate when bystanders assist patients who are not in cardiac arrest.
They conducted a prospective cohort study of adult patients not in cardiac arrest for whom dispatchers gave CPR instructions in King County, Washington, from June 1, 2004, to Jan. 31, 2007. The authors reviewed audio and written dispatch reports, written EMS reports, and hospital records, and they conducted a phone survey. Among 1,700 patients, 938 (55 percent) were in cardiac arrest, and 313 of the total (18 percent) were not in arrest but received chest compressions. For the 247 of these patients in arrest who received chest compressions and for whom complete outcomes were ascertained, 29 (12 percent) experienced discomfort and six (2 percent) sustained injuries probably or possibly caused by the CPR. Only five of the 247 patients suffered a fracture, and no patient suffered a visceral organ injury, according to the authors, who are affiliated with Public Health Seattle–King County's Emergency Medical Services Division (White, Bloomingdale, Fahrenbruch, Culley, Subido, Eisenberg, and Rea) and the University of Washington Department of Medicine (Rogers, Bloomingdale, Eisenberg, and Rea) in Seattle.
The results confirm the frequency of serious injury from dispatcher-aided bystander CPR among non-arrest patients is low. Given the benefits of bystander CPR for patients who are in arrest, the results support an assertive program of dispatcher-assisted CPR, the authors concluded.