title: Why bystanders decline telephone cardiac resuscitation advice.
abstract: OBJECTIVE
  The aim of this study was to evaluate the rate and reason for refusal of telephone-based cardiopulmonary resuscitation (CPR) instruction by bystanders after the implementation of the dispatch center's systematic telephone CPR protocol.
  
  
  METHODS
  Over a 15-month period the authors prospectively collected all case records from the emergency medical services (EMS) dispatch center when CPR had been proposed to the bystander calling in and recorded the reason for declining or not performing that the bystander spontaneously mentioned. All pediatric and adult traumatic and nontraumatic cases were included. Situations when resuscitation had been spontaneously initiated by bystanders were excluded.
  
  
  RESULTS
  During the study period, dispatchers proposed CPR on 264 occasions: 232 adult nontraumatic cases, 17 adult traumatic cases, and 15 pediatric (traumatic and nontraumatic) cases. The proposal was accepted in 163 cases (61.7%, 95% confidence interval [CI] = 54.6% to 66.5%), and CPR was eventually performed in 134 cases (51%, 95% CI = 43.2% to 55.3%). In 35 of the cases where resuscitation was not carried out, the condition of the patient or conditions at the scene made this decision medically appropriate. Of the remaining 95 cases, 55 were due to physical limitations of the caller, and 33 were due to emotional distress.
  
  
  CONCLUSIONS
  The telephone CPR acceptance rate of 62% in this study is comparable to those of other similar studies. Because bystanders' physical condition is one of the keys to success, the rate may not improve as the population ages.
authors.affiliation: Emergency Medical Services Dispatch Center, State of Vaud, Lausanne, Switzerland. fabrice.dami@chuv.ch
authors.forename: Fabrice
authors.initials: F
authors.lastname: Dami
authors.forename: Pierre-Nicolas
authors.initials: PN
authors.lastname: Carron
authors.forename: Laurent
authors.initials: L
authors.lastname: Praz
authors.forename: Vincent
authors.initials: V
authors.lastname: Fuchs
authors.forename: Bertrand
authors.initials: B
authors.lastname: Yersin
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data*; D004631:Emergency Medical Service Communication Systems; D004632:Emergency Medical Services / Q000379:methods; D006801:Humans; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013557:Switzerland; D013689:Telephone