A before–after interventional trial of dispatcher-assisted cardio-pulmonary resuscitation for out-of-hospital cardiac arrests in Singapore

• Published in: Resuscitation Vol. 102; pp. 85 - 93
• Main Authors: Harjanto, Sumitro, Na, May Xue Bi, Hao, Ying, Ng, Yih Yng, Doctor, Nausheen, Goh, E. Shaun, Leong, Benjamin Sieu-Hon, Gan, Han Nee, Chia, Michael Yih Chong, Tham, Lai Peng, Cheah, Si Oon, Shahidah, Nur, Hock, Marcus Ong Eng
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01-05-2016
• Subjects: Aged; Cardiac arrest; Cardiopulmonary resuscitation; Cardiopulmonary Resuscitation - methods; Dispatcher-assisted; Emergency; Emergency Medical Services - methods; Female; Follow-Up Studies; Humans; Male; Out-of-Hospital Cardiac Arrest - mortality; Out-of-Hospital Cardiac Arrest - physiopathology; Out-of-Hospital Cardiac Arrest - therapy; Prognosis; Recovery of Function; Registries; Retrospective Studies; Singapore - epidemiology; Survival; Survival Rate - trends; Time Factors; Survival; Cardiopulmonary resuscitation; Dispatcher-assisted; Cardiac arrest
• ISSN: 0300-9572; 1873-1570
• DOI: 10.1016/j.resuscitation.2016.02.014

Abstract Aim To evaluate the effects of a comprehensive dispatcher-assisted CPR (DACPR) training program on bystander CPR (BCPR) rate and the outcomes of out-of-hospital cardiac arrest (OHCA) in Singapore. Methods This is an initial program evaluation of a national DACPR intervention. A before–after analysis was conducted using OHCA cases retrieved from a local registry and DACPR information derived from audio recordings and ambulance notes. The primary outcomes were survival to admission, survival at 30 days post-arrest and good functional recovery. Results Data was collected before the intervention (April 2010 to December 2011), during the run-in period (January 2012 to June 2012) and after the intervention (July 2012 to February 2013). A total of 2968 cases were included in the study with a mean age of 65.6. Overall survival rate was 3.9% (116) with good functional recovery in 2.2% (66) of the patients. BCPR rate increased from 22.4% to 42.1% ( p < 0.001) with odds ratio (OR) of 2.52 (95% confidence interval [CI]: 2.09–3.04) and ROSC increased significantly from 26.5% to 31.2% ( p = 0.02) with OR of 1.26 (95%CI: 1.04–1.53) after the intervention. Significantly higher survival at 30 days was observed for patients who received BCPR from a trained person as compared to no BCPR ( p = 0.001, OR = 2.07 [95%CI: 1.41–3.02]) and DACPR ( p = 0.04, OR = 0.30 [95%CI: 0.04–2.18]). Conclusion A significant increase in BCPR and ROSC was observed after the intervention. There was a trend to suggest improved survival outcomes with the intervention pending further results from the trial.