CPR initiated after telephone-assisted instruction produces a better outcome of bystander-witnessed out-of-hospital cardiac arrests than no bystander CPR but is less effective than CPR on the bystander's own initiative

Introduction

Telephone CPR has been shown to increase the incidence of bystander CPR and is expected to improve the outcomes of out-of-hospital cardiac arrests (OHCAs). The aim of present study was to clarify if the outcomes of bystander-witnessed OHCAs having CC-only and conventional CPR following telephone CPR may be better than those having no bystander CPR and if the type (CC-only and conventional) and origin (following telephone CPR and on bystander's own initiative) may affect the outcomes of bystander-witnessed OHCAs with bystander CPR.

Methods

From the Japanese nationwide database for 431,968 OHCAs that occurred from January 2005 to December 2008, we extracted and analyzed 112,144 bystander-witnessed OHCAs without any involvement of physicians, using multiple logistic regression analysis.

Results

The analysis for all bystander-witnessed OHCAs revealed that both CC-only and conventional CPR following telephone CPR produce better outcomes than no bystander CPR (Table 1). The analysis for bystander-witnessed OHCAs with bystander CPR disclosed that CPR on the bystander's own initiative produces a better outcome than CPR following telephone CPR (Table 2).

Table 1 Comparison of survival between OHCAs without bystander CPR and bystander CPR in bystander-witnessed OHCAs

Table 2 Effects of type and origin by bystander CPR on survival of bystander-witnessed OHCAs having bystander CPR

Conclusion

Telephone CPR improves the outcomes of bystander-witnessed OHCAS. However, efforts to increase the incidence of early CPR on the bystander's own initiative would be necessary to obtain a higher incidence of survival in bystander-witnessed OHCAs.