Telecommunicator CPR can save lives following cardiac arrest

Telecommunicator CPR can save lives following cardiac arrest

A high-quality telecommunicator CPR program can save more lives from out-of-hospital cardiac arrest and strengthen the chain of survival, according to a new advisory published in Circulation by the American Heart Association, the world’s leading nonprofit organization focused on heart and brain health.

The advisory’s lead author, Michael Kurz, M.D., associate professor of the Department of Emergency Medicine at the University of Alabama at Birmingham, says CPR assistance rendered by 911 operators and dispatchers can reduce the mortality associated with out-of-hospital cardiac arrest.

Each year, an estimated 350,000 people experience sudden cardiac arrest in the United States in out-of-hospital environments. Sudden cardiac arrest is the unexpected loss of heart function, breathing and consciousness and is commonly the result of an electric disturbance in the heart. Only about one in 10 victims survives this traumatic event. Successful resuscitation of cardiac arrest victims requires immediate response to improve their chance of survival.

Telecommunicators, including call takers and dispatchers, are the true first responders and a critical link in the cardiac arrest chain of survival. Working with the 911 caller, telecommunicators have the first opportunity to identify a patient in cardiac arrest and provide initial care by delivering CPR instructions while quickly dispatching emergency medical services.

“The skill of the telecommunicator to engage the caller, identify the cardiac arrest and coach effective T-CPR could double or triple chances of survival from sudden cardiac arrest,” said Kurz, the immediate past-chair of the Emergency Cardiac Care subcommittee on systems of care for the American Heart Association. “Through these actions, the telecommunicator can make the difference between life and death.”

The advisory describes the public health impact of out-of-hospital cardiac arrest, provides guidance and resources to construct and maintain a T-CPR program, outlines the minimal acceptable standards for timely and high-quality delivery of T-CPR instructions, and identifies strategies to overcome common implementation barriers to T-CPR. The T-CPR process was previously described as dispatch CPR, dispatch-assisted CPR or telephone CPR.

The advisory takes the recommendations from the previous International Liaison Committee on Resuscitation and American Heart Association statements, which have addressed improved outcomes from T-CPR to increase lay-rescuer CPR and improve out-of-hospital cardiac arrest outcomes, and outlines the components that are needed to implement a science-based T-CPR program within a community.

An effective T-CPR program depends on several important operational commitments by the emergency response system, such as:

• Provide a high-quality program that includes measurement and performance goals
• Provide initial and ongoing education in T-CPR for all telecommunicators
• Conduct effective and continuous quality improvement
• Connect to an emergency medical services agency
• Designate a medical director
• Recognize outstanding performance

Effective T-CPR also depends on well-prepared professionals trained to elicit information quickly, interpret that information and provide direction. A quality improvement process should be established with clear, objective data sets, and specific individuals should be identified who are accountable for conducting reviews under the guidance of a physician to drive quality care.

“A program of T-CPR offers the safest, most cost-efficient and most effective approach to substantially increase community lay-rescuer CPR,” Kurz said. “Thousands of additional lives can be saved each year if we can achieve this goal; conversely, not meeting this goal represents a preventable harm as potential survivors of out-of-hospital cardiac arrest are lost.”