Evaluation of telephone-cardiopulmonary resuscitation advice for paediatric cardiac arrest.
BACKGROUND
Telephone-cardiopulmonary resuscitation (CPR) advice aims to increase the quality and quantity of bystander CPR, one of the few interventions shown to improve outcome in cardiac arrest. We evaluated a current paediatric telephone protocol (AMPDS v11.1) to assess the effectiveness of verbal CPR instructions in paediatric cardiac arrest.


METHODS
Consecutive emergency calls classified by the AMPDS as cardiac arrests in children <8 years old, over an 11 month period, were compared with their corresponding patient report forms (PRFs) to confirm the diagnosis. Audio recordings and PRFs were then evaluated to assess whether bystander CPR was given, and when it was, the time taken to perform CPR interventions, before paramedic arrival.


RESULTS
Of the 42 calls reviewed, 19 (45.2%) were confirmed as cardiac arrest. CPR was already underway in two cases (10.5%). Of the remaining callers, 11 (64.7%) agreed to attempt T-CPR, resulting in an overall bystander-CPR rate of 68.4%. The median time to open the airway was 126s (62-236s, n=11), deliver the first ventilation was 180s (135-360s, n=11), and perform the first chest compression was 280s (164-420s, n=9).


CONCLUSIONS
Although current telephone-CPR instructions improve the numbers of children in whom bystander CPR is attempted, effectiveness is likely to be limited by the significant delays in actually delivering basic life support.
Deakin
Charles D
CD
South Central Ambulance Service, Southern House, Sparrowgrove, Otterbourne, Hampshire, UK. charlesdeakin@doctors.org.uk
Evans
Siân
S
King
Philip
P
D016887:Cardiopulmonary Resuscitation / Q000379:methods* / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D015277:Hotlines; D006801:Humans; D007223:Infant; D008297:Male; D010372:Pediatrics; D011237:Predictive Value of Tests; D019114:Remote Consultation; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D013689:Telephone; D006113:United Kingdom