Nikolaou, Nikolaos, Dainty, Katie N., Couper, Keith, Morley, Peter, Tijssen, Janice and Vaillancourt, Christian (2019) A systematic review and meta-analysis of the effect of dispatcher-assisted CPR on outcomes from sudden cardiac arrest in adults and children. Resuscitation, 138 . pp. 82-105. doi:10.1016/j.resuscitation.2019.02.035 ISSN 0300-9572.
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Abstract
Background
Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) has been reported in individual studies to significantly increase the rate of bystander CPR and survival from cardiac arrest.
Methods
We undertook a systematic review and meta-analysis to evaluate the impact of DA-CPR programs on key clinical outcomes following out-of-hospital cardiac arrest. We searched the PubMED, EMBASE, CINAHL, ERIC and Cochrane Central Register of Controlled Trials databases from inception until July 2018. Eligible studies compared systems with and without dispatcher-assisted CPR programs. Included studies were divided into three groups: comparison of outcomes in systems providing DA-CPR; comparison of cases where DA-CPR was provided to cases where bystander CPR was ongoing, and DA-CPR was not provided; and comparison of cases where DA-CPR was provided to cases where no bystander CPR was provided (patient level comparisons). The GRADE system was used to assess certainty of evidence at an outcome level. We used random-effects models to produce summary effect sizes across all outcomes.
Results
Of 5,531 citations screened, 33 studies were eligible for inclusion. All included studies were observational. Evidence certainty across all outcomes was assessed as low or very low. In system-level and patient-level comparisons, the provision of DA-CPR compared with no DA-CPR was consistently associated with improved outcome across all analyses. Comparison of DA-CPR to bystander CPR produced conflicting results. Findings were consistent across sensitivity analyses and the pediatric sub-group.
Conclusion
These results support the recommendation that dispatchers provide CPR instructions to callers for adults and children with suspected OHCA.
| Item Type: | Journal Article |
|---|---|
| Subjects: | R Medicine > RC Internal medicine R Medicine > RJ Pediatrics |
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
| Library of Congress Subject Headings (LCSH): | Cardiac arrest, Cardiac arrest in children, CPR (First aid) |
| Journal or Publication Title: | Resuscitation |
| Publisher: | Elsevier Ireland Ltd |
| ISSN: | 0300-9572 |
| Official Date: | 8 March 2019 |
| Dates: | Date Event 8 March 2019 Available 24 February 2019 Accepted |
| Volume: | 138 |
| Page Range: | pp. 82-105 |
| DOI: | 10.1016/j.resuscitation.2019.02.035 |
| Status: | Peer Reviewed |
| Publication Status: | Published |
| Access rights to Published version: | Restricted or Subscription Access |
| Description: | On behalf of the International Liaison Committee on Resuscitation’s (ILCOR) Basic Life Support and Pediatric Task Forces |
| Date of first compliant deposit: | 28 February 2019 |
| Date of first compliant Open Access: | 8 March 2020 |
| RIOXX Funder/Project Grant: | Project/Grant ID RIOXX Funder Name Funder ID UNSPECIFIED Canadian Arrhythmia Network UNSPECIFIED UNSPECIFIED North York General Hospital (Toronto, Ont.) UNSPECIFIED |
| Related URLs: | |
| Contributors: | Contribution Name Contributor ID Research Group UNSPECIFIED UNSPECIFIED |
| URI: | https://wrap.warwick.ac.uk/114478/ |
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