title: Survey of a protocol to increase appropriate implementation of dispatcher-assisted cardiopulmonary resuscitation for out-of-hospital cardiac arrest.
abstract: BACKGROUND
  Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) attempts to improve the management of out-of-hospital cardiac arrest by laypersons who are unable to recognize cardiac arrest and are unfamiliar with CPR. Therefore, we investigated the sensitivity and specificity of our new DA-CPR protocol for achieving implementation of bystander CPR in out-of-hospital cardiac arrest victims not already receiving bystander CPR.
  
  
  RESULTS
  Since 2007, we have applied a new DA-CPR protocol that uses supplementary key words. Fire departments prospectively collected baseline data on DA-CPR from January 2009 to December 2011. DA-CPR was attempted in 2747 patients; of these, 417 (15.2%) did not experience cardiac arrest. The sensitivity and specificity of the 2007 protocol versus estimated values of the previous standard protocol were 72.9% versus 50.3% and 99.6% versus 99.8%, respectively. We identified key words that may be useful for detecting out-of-hospital cardiac arrest. Multiple logistic regression analysis revealed that the occurrence of cardiac arrest after an emergency call (odds ratio, 16.85) and placing an emergency call away from the scene of the arrest (odds ratio, 11.04) were potentially associated with failure to provide DA-CPR. Furthermore, at-home cardiac arrest (odds ratio, 1.61) and family members as bystanders (odds ratio, 1.55) were associated with bystander noncompliance with DA-CPR. No complications were reported in the 417 patients who received DA-CPR but did not have cardiac arrest.
  
  
  CONCLUSIONS
  Our 2007 protocol is safe and highly specific and may be more sensitive than the standard protocol. Understanding the factors associated with failure of bystanders to provide DA-CPR and implementing public education are necessary to increase the benefit of DA-CPR.
authors: Department of Emergency Medical Science, Kanazawa University Graduate School of Medicine, Kanazawa, Ishikawa, Japan (Y.T., T.N., K.T., H.I.); Department of Surgery, Tsuruga Municipal Hospital, Tsuruga, Fukui, Japan (Y.T.); Department of Anesthesia, Komatsu Municipal Hospital, Komatsu, Ishikawa, Japan (Y.Y.); Department of Emergency Medicine, Kanazawa Medical University, Kahoku, Ishikawa, Japan (Y.W.); Emergency Medical Center, Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan (J.T.); and Department of Neurosurgery, Suzu General Hospital, Suzu, Ishikawa, Japan (Y.H.).
authors: Yoshio
authors: Y
authors: Tanaka
authors: Taiki
authors: T
authors: Nishi
authors: Keiko
authors: K
authors: Takase
authors: Yutaka
authors: Y
authors: Yoshita
authors: Yukihiro
authors: Y
authors: Wato
authors: Junro
authors: J
authors: Taniguchi
authors: Yoshitaka
authors: Y
authors: Hamada
authors: Hideo
authors: H
authors: Inaba
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D004631:Emergency Medical Service Communication Systems / Q000592:standards / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D005190:Family; D005260:Female; D061388:Firefighters / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D011446:Prospective Studies; D012424:Rural Population / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity; D014505:Urban Population / Q000706:statistics & numerical data
keywords: cardiopulmonary resuscitation; out-of-hospital cardiac arrest