Cardiac arrest patients rarely receive chest
compressions before ambulance arrival despite
the availability of pre-arrival CPR instructions
Summary
Objectives: To determine the proportion of out-of-hospital cardiac arrest (OOHCA) patients who
received chest compressions, before EMS arrival, from bystanders who called the EMS emergency
telephone number (9-1-1) at dispatch centers that provided telephone CPR instructions and to
describe barriers to following instructions.
Methods: A retrospective case series was conducted in 2004 at three dispatch centers all of
which provided sequential airway, breathing and chest compression pre-arrival instructions. All
calls for which the call-taker established that the patient was in OOHCA were identified, and
the recorded interaction was reviewed using a structured data collection tool. Data included
whether the caller performed compressions, the sequence of instructions, whether there were
barriers to performing CPR and characteristics of the caller, call taker and patient. Descriptive
statistics were used to evaluate the data.
Results: 343 calls were reviewed. 3 were excluded because it was unclear whether compressions
were provided. 172 calls were not eligible for pre-arrival instructions (e.g. obviously dead,
already receiving CPR). Of the 168 calls eligible for CPR instructions, chest compressions were