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Paramedic CAT (Critically Appraised Topic)

006 | The effectiveness of video-assisted dispatcher-instructed bystander CPR instructions compared to telephone-only CPR

Author	Jennie Helmer	Date	2020-01-21
Reviewer	-	Edited	2020-10-22

Case Study

A call-taker receives a call for an unresponsive 68-year-old male. The call-taker, through using interactive video instruction, determines that the patient is unresponsive and not breathing. The call-taker begins video-CPR instructions to the caller, and the bystander begins CPR. The call-taker is able to visualize and correct the rate and hand-placement of the bystander.

PICO Question

“Does using interactive video instruction by Emergency Medical Call-Takers and Dispatchers better identify patients in cardiac arrest than without video?”

Population	Patients presented to Call-Taker/Dispatcher as unconscious and not breathing
Intervention	Video-assisted CPR instructions
Comparison	Audio-only T-CPR instructions
Outcome	Bystander CPR quality

Search Strategy

Pubmed: ((“Cardiac Arrest”) OR (“Unresponsive”)) AND ((“EMD”) OR (“Call-Taker”) OR (“Dispatcher”)) AND ((“Video CPR Instructions” OR “Audio CPR Instructions”)) AND (“Bystander CPR”)

Search Outcome

8 Results (4 Relevant) on 2020-01-21

Clinical Bottom Line

Video-instructed CPR significantly improves the time to initiate compressions, the chest compression rate, and a trend for correctness of hand position was also observed, compared to the audio-instructed method.

Relevant Results

Lin YY, Chiang WC, Hsieh MJ, Sun JT, Chang YC, Ma MH. Quality of audio-assisted versus video-assisted dispatcher-instructed bystander cardiopulmonary resuscitation: A systematic review and meta-analysis. 2018. [LINK]
Yang CW, Wang HC, Chiang WC, et al. Interactive video instruction improves the quality of dispatcher-assisted chest compression-only cardiopulmonary resuscitation in simulated cardiac arrests. Crit Care Med. 2009. [LINK]
Brinkrolf P, Metelmann B, Scharte C, Zarbock A, Hahnenkamp K, Bohn A. Bystander-witnessed cardiac arrest is associated with reported agonal breathing and leads to less frequent bystander CPR. 2018. [LINK]
Lee JS, Jeon WC, Ahn JH, Cho YJ, Jung YS, Kim GW. The effect of a cellular-phone video demonstration to improve the quality of dispatcher-assisted chest compression-only cardiopulmonary resuscitation as compared with audio coaching. 2011. [LINK]