Prompt dispatcher-initiated tele-CPR and facilitation of bystander's CPR to improve out-of-hospital cardiac arrest outcomes: A prospective cohort study from Finland

Abstract

Aim of the study: This study focused on the first link of the chain of survival by examining the dispatcher's ability to early recognition of the OHCA patient and assessing patient outcomes. Methods: This was a prospective cohort study that included patients who suffered OHCA in Pirkanmaa Finland in 2022. Two researchers listened to all calls separately determining key-time events of the call. All patients with confirmed recognisable OHCA during the call who had background data and audio recordings available were included. Results: We received 451 recordings, 246 of which met the inclusion criteria, and 217 (88 %) were recognised as OHCA. The beginning of tele-CPR guidance (1 min 20 sec vs 1 min 55 sec, p = 0.002) and initiation of bystander CPR (2 min 48 sec vs 3 min 50 sec, p = 0.012) were faster in cases with shockable rhythm on EMS arrival. Every minute of delay in the dispatcher initiating tele-CPR guidance decreased the probability of shockable initial rhythm by 23 % (OR 0.76 [0.61;0.95], p = 0.018). Shockable initial rhythm was more common among patients who were alive at three months after OHCA (83 % vs 21 %, p < 0.001). In multivariable analysis, shockable initial rhythm favoured 3-month survival (OR 16.67 [5.41;52.63], p < 0.001). Overall survival at three months was 12 % (29/246), of which 90 % (26/29) had a Cerebral Performance Category of 1–2. Conclusion: Quick tele-CPR guidance may be related to/ associated with improving the chances for shockable initial rhythm, thus further improving the chances for long-term survival.