title: A standardized template for measuring and reporting telephone pre-arrival cardiopulmonary resuscitation instructions.
abstract: BACKGROUND
  Bystander cardiopulmonary resuscitation (CPR) improves out-of-hospital cardiac arrest (OHCA) survival. Telephone CPR (TCPR) comprises CPR instruction given by emergency dispatchers to bystanders responding to OHCA and the CPR performed as a result. TCPR instructions improve bystander CPR rates, but the quality of the instructions varies widely. No standardized system exists to critically evaluate the TCPR intervention.
  
  
  METHODS
  Investigators analyzed audio recordings of suspected OHCA calls from a large regional 9-1-1 dispatch center and applied descriptive terms, a data collection tool and a six metric reporting template to describe TCPR. Data were obtained from October 2010 to November 2011. Dispatcher recognition of CPR need, delivery of TCPR instructions, and bystander CPR performance were documented.
  
  
  RESULTS
  A total of 590 calls were analyzed. Call evaluators achieved "near perfect agreement" with 5/6 reporting metrics and "strong agreement" on the 6th metric: percentage of calls where need for CPR was recognized by dispatch. CPR was indicated in 317 calls and already in progress in 94. Dispatchers recognized the need for TCPR in 176 of the 223 (79%) remaining calls. CPR instructions were started in 65/223 (29%) and bystander CPR resulting from TCPR instructions was started in 31/223 (14%).
  
  
  CONCLUSIONS
  We developed and demonstrated successful implementation of a simple data collection and reporting system for critical evaluation of the TCPR intervention. A standardized methodology for measuring TCPR is necessary to perform on-going quality improvement, to establish performance standards, and for future research on how to optimize bystander CPR rates and OHCA survival.
authors.affiliation: University of Arizona, Phoenix, AZ, United States.
authors.forename: Christian
authors.initials: C
authors.lastname: Dameff
authors.affiliation: Mayo Clinic, Jacksonville, FL, United States. Electronic address: vadeboncoeur.tyler@mayo.edu.
authors.forename: Tyler
authors.initials: T
authors.lastname: Vadeboncoeur
authors.affiliation: University of Arizona, Phoenix, AZ, United States.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Tully
authors.affiliation: Arizona Department of Health Services, Phoenix, AZ, United States.
authors.forename: Micah
authors.initials: M
authors.lastname: Panczyk
authors.affiliation: University of Arizona, Phoenix, AZ, United States.
authors.forename: Aaron
authors.initials: A
authors.lastname: Dunham
authors.affiliation: University of Arizona, Phoenix, AZ, United States.
authors.forename: Ryan
authors.initials: R
authors.lastname: Murphy
authors.affiliation: University of Arizona, Tucson, AZ, United States.
authors.forename: Uwe
authors.initials: U
authors.lastname: Stolz
authors.affiliation: University of Arizona, Phoenix, AZ, United States; Arizona Department of Health Services, Phoenix, AZ, United States.
authors.forename: Vatsal
authors.initials: V
authors.lastname: Chikani
authors.affiliation: University of Arizona, Tucson, AZ, United States.
authors.forename: Daniel
authors.initials: D
authors.lastname: Spaite
authors.affiliation: University of Arizona, Phoenix, AZ, United States; Arizona Department of Health Services, Phoenix, AZ, United States; Maricopa Medical Center, Phoenix, AZ, United States.
authors.forename: Bentley
authors.initials: B
authors.lastname: Bobrow
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000379:methods* / Q000592:standards; D004631:Emergency Medical Service Communication Systems / Q000592:standards*; D006801:Humans; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D012015:Reference Standards; D015203:Reproducibility of Results; D013689:Telephone; D013997:Time Factors
keywords: Basic life support; Cardiac arrest; Cardiopulmonary resuscitation