title: Dispatcher instruction of chest compression-only CPR increases actual provision of bystander CPR.
abstract: BACKGROUND
  A preceding randomized controlled trial demonstrated that chest compression-only cardiopulmonary resuscitation (CPR) instruction by dispatcher was more effective to increase bystander CPR than conventional CPR instruction. However, the actual condition of implementation of each type of dispatcher instruction (chest compression-only CPR [CCCPR] or conventional CPR with rescue breathing) and provision of bystander CPR in real prehospital settings has not been sufficiently investigated.
  
  
  METHODS
  This registry prospectively enrolled patients aged =>18 years suffering an out-of-hospital cardiac arrest (OHCA) of non-traumatic causes before emergency-medical-service (EMS) arrival, who were considered as target subjects of dispatcher instruction, resuscitated by EMS personnel, and transported to medical institutions in Osaka, Japan from January 2005 through December 2012. The primary outcome measure was provision of CPR by a bystander. Multiple logistic regression analysis was used to assess factors that were potentially associated with provision of bystander CPR.
  
  
  RESULTS
  Among 37,283 target subjects of dispatcher instruction, 5743 received CCCPR instruction and 13,926 received conventional CPR instruction. The proportion of CCCPR instruction increased from 5.7% in 2005 to 25.6% in 2012 (p for trend <0.001). The CCCPR instruction group received bystander CPR more frequently than conventional CPR instruction group (70.0% versus 62.1%, p<0.001). In the multivariable analysis, CCCPR dispatcher instruction was significantly associated with provision of bystander CPR compared with conventional CPR instruction (adjusted odds ratio 1.44, 95% CI 1.34-1.55).
  
  
  CONCLUSIONS
  CCCPR dispatcher instruction among adult OHCA patients significantly increased the actual provision of bystander CPR.
authors.affiliation: Kyoto University Health Service, Yoshida-Honmachi, Sakyo-ku, Kyoto 606-8501, Japan.
authors.forename: Tomonari
authors.initials: T
authors.lastname: Shimamoto
authors.affiliation: Kyoto University Health Service, Yoshida-Honmachi, Sakyo-ku, Kyoto 606-8501, Japan. Electronic address: iwami.taku.8w@kyoto-u.ac.jp.
authors.forename: Taku
authors.initials: T
authors.lastname: Iwami
authors.affiliation: Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, 2-2 Ymamada-oka, Suita, Osaka 565-0871, Japan.
authors.forename: Tetsuhisa
authors.initials: T
authors.lastname: Kitamura
authors.affiliation: Department of Critical Care Nursing, Kyoto University Graduate School of Human Health Science, 53 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Chika
authors.initials: C
authors.lastname: Nishiyama
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamada-oka, Suita, Osaka 565-0871, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Sakai
authors.affiliation: Department of Acute Medicine, Kinki University Faculty of Medicine, 377-2 Ohno-Higashi Osaka-Sayama, Osaka 589-8511, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nishiuchi
authors.affiliation: Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital, 1-1-6 Tsukumodai, Suita, Osaka 565-0862, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Hayashi
authors.affiliation: Kyoto University Health Service, Yoshida-Honmachi, Sakyo-ku, Kyoto 606-8501, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawamura
mesh_terms: D000293:Adolescent; D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000592:standards*; D004631:Emergency Medical Service Communication Systems / Q000458:organization & administration*; D005260:Female; D006336:Heart Massage / Q000379:methods*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000453:epidemiology / Q000628:therapy*; D011159:Population Surveillance / Q000379:methods*; D011312:Pressure; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends; D013909:Thorax; D016896:Treatment Outcome; D055815:Young Adult
keywords: Bystander; Cardiac arrest; Cardiopulmonary resuscitation; Chest compression-only; Dispatcher instruction