title: Communication and protocol compliance and their relation to the quality of cardiopulmonary resuscitation (CPR): A mixed-methods study of simulated telephone-assisted CPR.
abstract: BACKGROUND
  In the event of a cardiac arrest, emergency medical dispatchers (EMDs) play a critical role by providing telephone-assisted cardiopulmonary resuscitation (T-CPR) to laypersons. The aim of our investigation was to describe compliance with the T-CPR protocol, the performance of the laypersons in a simulated T-CPR situation, and the communication between laypersons and EMDs during these actions.
  
  
  METHODS
  We conducted a retrospective observational study by analysing 20 recorded video and audio files. In a simulation, EMDs provided laypersons with instructions following T-CPR protocols. These were then analysed using a mixed method with convergent parallel design.
  
  
  RESULTS
  If the EMDs complied with the T-CPR protocol, the laypersons performed the correct procedures in 71% of the actions. The single most challenging instruction of the T-CPR protocol, for both EMDs and laypersons, was airway control. Mean values for compression depth and frequency did not reach established guideline goals for CPR.
  
  
  CONCLUSIONS
  Proper application of T-CPR protocols by EMDs resulted in better performance by laypersons in CPR. The most problematic task for EMDs as well for laypersons was airway management. The study results did not establish that the quality of communication between EMDs and laypersons performing CPR in a cardiac arrest situation led to statistically different outcomes, as measured by the quality and effectiveness of the CPR delivered.
authors: Department of Health Sciences, Luleå University of Technology, Lulea, Sweden. Electronic address: helena.nord.ljungquist@ltu.se.
authors: Helena
authors: H
authors: Nord-Ljungquist
authors: Strategic Research Program in Health Care Sciences (SFO-V), 'Bridging Research, Practice for Better Health', Department of Nursing, Umeå University, Umeå, Sweden.
authors: Margareta
authors: M
authors: Brännström
authors: Department of Clinical Science, Education, Karolinska Institutet, Södersjukhuset, Sweden.
authors: Katarina
authors: K
authors: Bohm
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000592:standards*; D003142:Communication; D004631:Emergency Medical Service Communication Systems; D019983:Guideline Adherence; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D010865:Pilot Projects; D012189:Retrospective Studies; D013548:Sweden; D013689:Telephone
keywords: Communication; Emergency medical dispatcher (EMD); Laypersons; Mixed method; Telephone-assisted cardiopulmonary resuscitation (T-CPR)