title: A novel protocol for dispatcher assisted CPR improves CPR quality and motivation among rescuers-A randomized controlled simulation study.
abstract: Emergency dispatchers use protocols to instruct bystanders in cardiopulmonary resuscitation (CPR). Studies changing one element in the dispatcher's protocol report improved CPR quality. Whether several changes interact is unknown and the effect of combining multiple changes previously reported to improve CPR quality into one protocol remains to be investigated. We hypothesize that a novel dispatch protocol, combining multiple beneficial elements improves CPR quality compared with a standard protocol.
  
  
  
  A novel dispatch protocol was designed including wording on chest compressions, using a metronome, regular encouragements and a 10-s rest each minute. In a simulated cardiac arrest scenario, laypersons were randomized to perform single-rescuer CPR guided with the novel or the standard protocol.
  
  
  
  a composite endpoint of time to first compression, hand position, compression depth and rate and hands-off time (maximum score: 22 points). Afterwards participants answered a questionnaire evaluating the dispatcher assistance.
  
  
  
  The novel protocol (n=61) improved CPR quality score compared with the standard protocol (n=64) (mean (SD): 18.6 (1.4)) points vs. 17.5 (1.7) points, p<0.001. The novel protocol resulted in deeper chest compressions (mean (SD): 58 (12)mm vs. 52 (13)mm, p=0.02) and improved rate of correct hand position (61% vs. 36%, p=0.01) compared with the standard protocol. In both protocols hands-off time was short. The novel protocol improved motivation among rescuers compared with the standard protocol (p=0.002).
  
  
  
  Participants guided with a standard dispatch protocol performed high quality CPR. A novel bundle of care protocol improved CPR quality score and motivation among rescuers.
authors.affiliation: Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 30, 8000 Aarhus C, Denmark.
authors.forename: Stinne Eika
authors.initials: SE
authors.lastname: Rasmussen
authors.affiliation: Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 30, 8000 Aarhus C, Denmark.
authors.forename: Mette Amalie
authors.initials: MA
authors.lastname: Nebsbjerg
authors.affiliation: Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 30, 8000 Aarhus C, Denmark.
authors.forename: Lise Qvirin
authors.initials: LQ
authors.lastname: Krogh
authors.affiliation: Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 30, 8000 Aarhus C, Denmark.
authors.forename: Katrine
authors.initials: K
authors.lastname: Bjørnshave
authors.affiliation: Center for Health Sciences Education, Aarhus University, Palle Juul-Jensens Boulevard 82, Building B, 8200 Aarhus N, Denmark; Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
authors.forename: Kristian
authors.initials: K
authors.lastname: Krogh
authors.affiliation: Institute of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark; Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 9, 8200 Aarhus N, Denmark.
authors.forename: Jonas Agerlund
authors.initials: JA
authors.lastname: Povlsen
authors.affiliation: Prehospital Emergency Medical Services, Central Denmark Region, Olof Palmes Allé 34, 1st floor, 8200 Aarhus N, Denmark.
authors.forename: Ingunn Skogstad
authors.initials: IS
authors.lastname: Riddervold
authors.affiliation: Department of Anaesthesiology and Intensive Care, Regional Hospital of Randers, Skovlyvej 1, 8930 Randers, Denmark.
authors.forename: Thorbjørn
authors.initials: T
authors.lastname: Grøfte
authors.affiliation: Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 30, 8000 Aarhus C, Denmark.
authors.forename: Hans
authors.initials: H
authors.lastname: Kirkegaard
authors.affiliation: Research Center for Emergency Medicine, Aarhus University Hospital, Nørrebrogade 44, Building 30, 8000 Aarhus C, Denmark; Institute of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark; Department of Internal Medicine, Regional Hospital of Randers, Skovlyvej 1, 8930 Randers, Denmark. Electronic address: bl@clin.au.dk.
authors.forename: Bo
authors.initials: B
authors.lastname: Løfgren
mesh_terms: D000328:Adult; D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000523:psychology / Q000592:standards; D002985:Clinical Protocols; D003718:Denmark; D000071820:Emergency Medical Dispatch / Q000379:methods / Q000592:standards; D004631:Emergency Medical Service Communication Systems / Q000458:organization & administration / Q000592:standards; D005260:Female; D006282:Health Personnel / Q000523:psychology / Q000592:standards; D006336:Heart Massage / Q000379:methods; D006801:Humans; D008297:Male; D009042:Motivation; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D058996:Quality Improvement; D000066908:Simulation Training / Q000379:methods; D000078329:Workforce
keywords: Bystander; Cardiac arrest; Cardiopulmonary resuscitation; Dispatcher assistance