Effects of Dispatcher-assisted Cardiopulmonary Resuscitation on Survival Outcomes in Infants, Children, and Adolescents with Out-of-hospital Cardiac Arrests.

Abstract

Objective We studied the effect of a dispatcher-assisted cardiopulmonary resuscitation (CPR) program on paediatric out-of-hospital cardiac arrest (OHCA) outcomes by age groups.

Methods All emergency medical services (EMS)-treated paediatric OHCAs in Korea were enrolled between 2012 and 2014, excluding cases witnessed by EMS providers and those with unknown outcomes. The cases were divided into three groups: bystander CPR with dispatcher assistance, bystander CPR without dispatcher assistance, and no-bystander CPR. The endpoint was survival until discharge from hospital. Multivariable logistic regression analysis was performed. The final model with an interaction term was evaluated to compare the effects across age groups.

Results A total of 1529 patients (32.8% bystander CPR with dispatcher assistance, 17.3% without dispatcher assistance, and 54.6% no-bystander CPR) were included. Both bystander CPR groups were more likely to have higher rate of survival to discharge (8.8% and 12.1%) compared to no-bystander CPR (3.9%). The adjusted OR (95% CI) for survival to discharge were 1.77 (1.04-3.00) in bystander CPR with dispatcher assistance and 2.86 (1.61-5.08) in without dispatcher assistance compared with no-bystander CPR. By age groups, the adjusted OR (95% CI) in bystander CPR with and without dispatcher assistance were 2.18 (1.07-4.42) and 2.27 (1.01-5.14) for the group aged 9-18 years; 2.32 (0.64-8.44) and 6.21 (1.83-21.01) for the group aged 1-8 years; 1.06 (0.41-2.77) and 2.00 (0.64-6.18) for the group aged 0-12 months, respectively.

Conclusions Bystander CPR, regardless of dispatcher assistance, was associated with improved survival outcomes after OHCA in the paediatric population. However, the associations between dispatcher-assisted bystander CPR and survival outcomes varied by age.