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Dispatcher-Assisted Bystander CPR in Children Is Associated with Improved Neurological Outcomes

April 30, 2014

Dispatcher-Assisted Bystander CPR in Children Is Associated with Improved Neurological Outcomes

  1. Kristi L. Koenig, MD, FACEP, FIFEM

A nationwide observational study in Japan showed better 1-month neurological outcomes when prehospital dispatchers offered bystanders CPR instructions.

  1. Kristi L. Koenig, MD, FACEP, FIFEM

Dispatcher-assisted bystander cardiopulmonary resuscitation (CPR) is used for adults with out-of-hospital-cardiac arrest; however data on its effectiveness in children are scarce. Investigators analyzed data from a national Utstein-style Japanese registry for 5009 children (age <18 years) with out-of-hospital-cardiac arrest from 2008 to 2010. Children were divided into three groups: no bystander CPR (2287); bystander CPR with dispatcher assistance (2019); and bystander CPR without dispatcher assistance (703).

Dispatcher CPR instruction (offered in 54% of cases) significantly increased the rate of bystander CPR (adjusted odds ratio, 7.5). Bystander CPR, both with and without dispatcher assistance, was associated with better 1-month neurological outcomes (adjusted ORs, 1.8 and 1.7, respectively). Whereas conventional CPR was associated with better neurological outcomes at 1-month, chest-compression–only CPR was not.

Comment

Dispatcher CPR instruction dramatically increases the likelihood that bystander CPR will be performed. This effect alone justifies universal adoption of this simple practice.

  • Disclosures for Kristi L. Koenig, MD, FACEP, FIFEM at time of publication Editorial boards Koenig & Schultz's Disaster Medicine: Comprehensive Principles and Practices

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