Effect of introduction of a standardized protocol in dispatcher-assisted cardiopulmonary resuscitation.
The two most commonly used dispatch tools are medical priority dispatch (MPD) and criteria based dispatch (CBD), but there are countries still using non-standardized emergency call processing. We compared selected characteristics of DA-CPR before and after implementation of a standardized protocol in a non-MPD and non-CBD system.



Observational study of DA-CPR recordings during 4-month periods before (PER1) and after (PER2) the standardized protocol had been implemented. Selected performance characteristics included times to event verification, identification of cardiac arrest, DA-CPR instructions, and first chest compression, which were compared between PER1 and PER2. The secondary goal was to compare survival to hospital discharge.



A total of 152 call recordings with DA-CPR were evaluated in PER1 and 174 in PER2. Median times to cardiac arrest recognition were 46s in PER1 and 37s in PER2 (p=0.002), to first compression 2min 35s in PER1 and 2min 25s in PER2 (p=0.549). Admission to hospital with return of spontaneous circulation (ROSC) was achieved in 39 patients (31.9%) in PER1 and 57 (45.6%) in PER2 (p<0.05), discharge from hospital (CPC 1-2) in 9.0% and 14.4% patients in PER1 and PER2, respectively. If ventricular fibrillation was the initial rhythm, survival rate (CPC 1-2) was 32.3% in PER1 and 38.7% in PER2 (p=0.523).



Implementation of a standardized DA-CPR protocol resulted in faster identification of cardiac arrest, response team dispatching and arrival at scene. These factors were associated with a trend to better survival.
Faculty of Military Health Sciences, University of Defence, Trebesska 1575, 500 01 Hradec Kralove, Czech Republic; Emergency Medical Services of the Hradec Kralove Region, Hradecka 1690/2A, 500 12 Hradec Kralove, Czech Republic.
Michal
M
Plodr
Emergency Medical Services of the Hradec Kralove Region, Hradecka 1690/2A, 500 12 Hradec Kralove, Czech Republic; Department of Anaesthesiology and Intensive Care Medicine, Charles University Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic. Electronic address: anatolij.truhlar@gmail.com.
Anatolij
A
Truhlar
Emergency Medical Services of the Hradec Kralove Region, Hradecka 1690/2A, 500 12 Hradec Kralove, Czech Republic.
Jaroslava
J
Krencikova
Emergency Medical Services of the Hradec Kralove Region, Hradecka 1690/2A, 500 12 Hradec Kralove, Czech Republic.
Monika
M
Praunova
Emergency Medical Services of the Hradec Kralove Region, Hradecka 1690/2A, 500 12 Hradec Kralove, Czech Republic.
Vladimir
V
Svaba
Emergency Medical Services of the Hradec Kralove Region, Hradecka 1690/2A, 500 12 Hradec Kralove, Czech Republic.
Jiri
J
Masek
Emergency Medical Services of the Hradec Kralove Region, Hradecka 1690/2A, 500 12 Hradec Kralove, Czech Republic.
Dana
D
Bejrova
Faculty of Military Health Sciences, University of Defence, Trebesska 1575, 500 01 Hradec Kralove, Czech Republic.
Jiri
J
Paral
D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D018153:Czech Republic; D004631:Emergency Medical Service Communication Systems / Q000458:organization & administration / Q000592:standards*; D004638:Emergency Treatment / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D013689:Telephone; D013997:Time Factors
Dispatcher-assisted cardiopulmonary resuscitation; Emergency medical dispatch centre; Out-of-hospital cardiac arrest