Abstract 245: Dispatcher Assisted Cardiopulmonary Resuscitation in Patients Not in Cardiac Arrest: A Multi-Center, Observation Study

• Published in: Circulation (New York, N.Y.) N.Y.), 2020-11, Vol.142 (Suppl_4)
• Main Authors: Ng, Julia YX, Sim, Zariel J, Siddiqui, Fahad J, Shahidah, Nur, Leong, Benjamin SH, Tiah, Ling, Ng, Yih Yng, Arulanandam, Shalini, Ho, Andrew FW, Ong, Marcus E
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.142.suppl_4.245

Abstract only Background: Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) can increase bystander CPR rates and improve outcomes in out-of-hospital cardiac arrest (OHCA). Protocols used by dispatchers are designed to provide a quick assessment for prompt initiation of CPR. However, there are instances where non-cardiac arrest cases are falsely recognised by dispatchers to be in cardiac arrest. These patients may go on to receive chest compressions and potentially suffer from complications of unnecessary CPR, though the clinical implications of starting DA-CPR on these non-cardiac arrest cases have not been studied. Hence, the objectives of this study are to find the prevalence and clinical outcomes of DA-CPR in patients not in cardiac arrest in the Singapore population. Methods: This was a multi-center, observational study of all dispatcher-recognized cardiac arrests cases between January to December 2017 involving three tertiary hospitals in Singapore. Data was collected through audio review of dispatch calls from the national emergency ambulance service and information about patients’ clinical outcomes were prospectively collected from health records. Results: During the study period, dispatchers recognised 821 patients as having cardiac arrest. Of these, 40.0% (328/ 821) were not in cardiac arrest. 52.7% (173/ 328) of the non-cardiac arrest patients had chest compressions initiated under dispatcher assistance. No complications from chest compressions were reported. The top diagnoses of non-cardiac arrest patients found were cerebrovascular accidents (CVA), syncope and infection. A multiple logistic regression model with estimates adjusted for the presence or absence of chest compressions revealed that only final diagnoses of CVA (OR 20.68), infection (OR 17.34) and myocardial infarction (OR 32.19) were associated with in-hospital mortality. Conclusion: In this study, chest compressions initiated due to false recognition of cardiac arrest by dispatchers did not result in any reported complications and was not associated with in-hospital mortality. This provides reassurance for the continued implementation of DA-CPR.