title: Barriers to telephone cardiopulmonary resuscitation in public and residential locations.
abstract: Emergency medical telecommunicators can play a key role in improving outcomes from out-of-hospital cardiac arrest (OHCA) by providing instructions for cardiopulmonary resuscitation (CPR) to callers. Telecommunicators, however, frequently encounter barriers that obstruct the Telephone CPR (TCPR) process. The nature and frequency of these barriers in public and residential locations have not been well investigated. The aim of this study is to identify the barriers to TCPR in public and residential locations.
  
  
  
  We conducted a retrospective study of audio recordings of EMS-confirmed OHCAs from eight regional 9-1-1 dispatch centers between January 2012 and December 2013.
  
  
  
  We reviewed 1850 eligible cases (public location OHCAs: N=223 and residential location OHCAs: N=1627). Telecommunicators less frequently encountered barriers such as inability to calm callers in public than in residential locations (2.1% vs 8.5%, p=0.002) or inability to place victims on a hard flat surface (13.9% vs 25.4%, p<0.001). However, the barrier where callers were not with patients was more frequently observed in public than in residential locations (11.8% vs 2.7%, p<0.001).
  
  
  
  This study revealed that barriers to TCPR are distributed differently across public and residential locations. Understanding these differences can aid in the development of strategies to enhance bystander CPR and improve overall patient outcomes.
authors: Arizona Department of Health Services, Bureau of EMS and Trauma System, 150 North 18th Avenue, Phoenix, AZ 85007, United States; University of Arizona, Department of Emergency Medicine, Arizona Emergency Medicine Research Center, 714 East Van Buren St, Phoenix, AZ 85006, United States; Department of Emergency and Critical Care Medicine, Nara Medical University, Shijo-cho, 840, Kashihara City, Nara 6348522, Japan. Electronic address: hidetakarina@gmail.com.
authors: Hidetada
authors: H
authors: Fukushima
authors: Arizona Department of Health Services, Bureau of EMS and Trauma System, 150 North 18th Avenue, Phoenix, AZ 85007, United States.
authors: Micah
authors: M
authors: Panczyk
authors: University of Arizona, Department of Emergency Medicine, Arizona Emergency Medicine Research Center, 714 East Van Buren St, Phoenix, AZ 85006, United States.
authors: Daniel W
authors: DW
authors: Spaite
authors: Arizona Department of Health Services, Bureau of EMS and Trauma System, 150 North 18th Avenue, Phoenix, AZ 85007, United States.
authors: Vatsal
authors: V
authors: Chikani
authors: University of Arizona College of Medicine Phoenix, 550 East Van Buren St, Phoenix, AZ 85004, United States; Maricopa Medical Center, 2601 East Roosevelt St, Phoenix, AZ 85008, United States.
authors: Christian
authors: C
authors: Dameff
authors: University of Arizona, Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, 1295 North, Martin Avenue, Tucson, AZ 85724, United States.
authors: Chengcheng
authors: C
authors: Hu
authors: Laerdal Medical AS, Tanke Svilandsgate 30, N-4002 Stavanger, Norway.
authors: Tonje S
authors: TS
authors: Birkenes
authors: Laerdal Medical AS, Tanke Svilandsgate 30, N-4002 Stavanger, Norway.
authors: Helge
authors: H
authors: Myklebust
authors: University of Arizona College of Medicine Phoenix, 550 East Van Buren St, Phoenix, AZ 85004, United States.
authors: John
authors: J
authors: Sutter
authors: Arizona State University, School of Mathematical and Statistical Science, University Drive and Mill Avenue, Tempe, AZ 85287, United States.
authors: Blake
authors: B
authors: Langlais
authors: Arizona Department of Health Services, Bureau of EMS and Trauma System, 150 North 18th Avenue, Phoenix, AZ 85007, United States; University of Arizona, Department of Emergency Medicine, Arizona Emergency Medicine Research Center, 714 East Van Buren St, Phoenix, AZ 85006, United States.
authors: Zhixin
authors: Z
authors: Wu
authors: Arizona Department of Health Services, Bureau of EMS and Trauma System, 150 North 18th Avenue, Phoenix, AZ 85007, United States; University of Arizona, Department of Emergency Medicine, Arizona Emergency Medicine Research Center, 714 East Van Buren St, Phoenix, AZ 85006, United States; University of Arizona College of Medicine Phoenix, 550 East Van Buren St, Phoenix, AZ 85004, United States.
authors: Bentley J
authors: BJ
authors: Bobrow
mesh_terms: D000328:Adult; D000368:Aged; D016887:Cardiopulmonary Resuscitation; D004631:Emergency Medical Service Communication Systems; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D012189:Retrospective Studies; D013689:Telephone
keywords: Basic life support; Cardiac arrest; Cardiopulmonary resuscitation; Telephone CPR