title: Predictive factors of successful telephone-assisted cardiopulmonary resuscitation.
abstract: BACKGROUND
  Our emergency medical service developed a telephone (phone)-assisted cardiopulmonary resuscitation (PACPR) procedure.
  
  
  OBJECTIVE
  To describe this procedure and study the factors modulating its implementation.
  
  
  METHODS
  We conducted a single-center prospective study of telephone calls to our emergency medical communication center for cardiac arrest, for which PACPR was initiated.
  
  
  RESULTS
  Thirty-eight patients were included in the study. In six cases, cardiopulmonary resuscitation (CPR) had been started before the call. When PACPR was initiated, CPR was performed until the rescue team arrived in 27 cases. One-third (n = 9) of the bystanders in these cases knew first-aid interventions, and all of these bystanders continued CPR until the rescue team arrived. The absence of a familial relationship between bystander and patient facilitated the continuation of CPR (100% vs. 37% with family ties, p = 0.01). CPR was continued more often if the bystander immediately agreed to PACPR than when he or she did not agree at first (88% vs. 45%, respectively, p = 0.01). When an obstacle to performing CPR was encountered, CPR was then performed in 57% of cases vs. 100% of cases with no obstacle (p = 0.003). These obstacles were associated with either the bystander (panic, apprehension, feelings of inadequacy, physical inability, indirect witness, tiredness) or the victim (morphotype, physical position). The presence of an obstacle, compared to no obstacle, associated with the bystander lowered the CPR performance rate (58% vs. 94%, respectively, p = 0.01). The presence of an obstacle, compared to no obstacle, associated with the victim also lowered CPR performance rate (50% vs. 85%, respectively, p = 0.04).
  
  
  CONCLUSIONS
  Our study demonstrates the feasibility of PACPR. The results may lead to a better understanding of facilitating factors and obstacles to telephone-assisted CPR, with the goal of improving its implementation. Good command of communication tools, identification of an appropriate bystander, and appropriate victim positioning are three fundamental factors of success.
authors.affiliation: Pôle Urgences, Centre Hospitalier Universitaire de Nantes, Nantes, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Martinage
authors.forename: Yann
authors.initials: Y
authors.lastname: Penverne
authors.forename: Philippe
authors.initials: P
authors.lastname: Le Conte
authors.forename: Marie
authors.initials: M
authors.lastname: San Miguel
authors.forename: Joël
authors.initials: J
authors.lastname: Jenvrin
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Montassier
authors.forename: Frédéric
authors.initials: F
authors.lastname: Berthier
authors.forename: Gilles
authors.initials: G
authors.lastname: Potel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D002648:Child; D002675:Child, Preschool; D004631:Emergency Medical Service Communication Systems; D004632:Emergency Medical Services; D005260:Female; D005602:France; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D011187:Posture; D011446:Prospective Studies; D013663:Teaching / Q000379:methods*; D013689:Telephone; D055815:Young Adult