The use of dispatcher assistance in improving the quality of cardiopulmonary resuscitation: A randomised controlled trial

Resuscitation. 2019 May;138:153-159. doi: 10.1016/j.resuscitation.2019.03.003. Epub 2019 Mar 12.


Aims: The introduction of dispatcher assistance (DA) services has led to increased bystander cardiopulmonary resuscitation (CPR) participation rates. However, the extent to which DA improves CPR quality remains unclear. This study aimed to evaluate the efficacy of DA in improving CPR quality among healthcare professionals and laypersons within a multi-ethnic Southeast Asian population.

Methods: A parallel, randomised controlled, open label trial was performed. Four hundred and twelve participants were recruited via convenience sampling in a public location. In a simulated cardiac-arrest scenario, the participants were randomised to perform CPR with DA over the phone (DA+) or CPR without DA (DA-). The ratio of participant assignment to DA+ and DA- was 1:1. The primary outcomes were CPR compression depth, compression rate, no-flow time, complete release of pressure between compressions, and hand location. The assessment involved CPR manikins and human assessors.

Results: A larger proportion of participants in DA + achieved the correct compression rate (34.3% vs 18.1%, p < 0.001). There was no difference in the other primary outcomes. A subgroup analysis revealed that healthcare professionals in DA+ had a higher proportion of correct hand location compared to those in DA- (82.1% vs. 53.5%, p < 0.05). There was no significant difference in CPR quality among laypersons with valid CPR certification regardless of whether they received DA.

Conclusion: DA should be provided to laypersons without valid CPR certification, as well as healthcare professionals. The identification of gaps in the current DA protocol highlights areas where specific changes can be made to improve CPR quality.

Keywords: CPR certification; Cardiopulmonary resuscitation; Dispatcher assistance; Healthcare professionals; Randomized controlled trial.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Validation Study

MeSH terms

  • Aged
  • Cardiopulmonary Resuscitation / standards*
  • Emergency Medical Service Communication Systems / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Global Health
  • Humans
  • Male
  • Middle Aged
  • Out-of-Hospital Cardiac Arrest / mortality
  • Out-of-Hospital Cardiac Arrest / therapy*
  • Quality of Health Care*
  • Registries*
  • Reproducibility of Results
  • Retrospective Studies
  • Survival Rate / trends