BACKGROUND Cardiac arrest is the leading cause of mortality in Canada, and the overall survival rate for out-of-hospital cardiac arrest rarely exceeds 5%. Bystander cardiopulmonary resuscitation (CPR) has been shown to increase survival for cardiac arrest victims. However, bystander CPR rates remain low in Canada, rarely exceeding 15%, despite various attempts to improve them. Dispatch-assisted CPR instructions have the potential to improve rates of bystander CPR and many Canadian urban communities now offer instructions to callers reporting a victim in cardiac arrest. Dispatch-assisted CPR instructions are recommended by the International Guidelines on Emergency Cardiovascular Care, but their ability to improve cardiac arrest survival remains unclear. METHODS/DESIGN The overall goal of this study is to better understand the factors leading to successful dispatch-assisted CPR instructions and to ultimately save the lives of more cardiac arrest patients. The study will utilize a before-after, prospective cohort design to specifically: 1) Determine the ability of 9-1-1 dispatchers to correctly diagnose cardiac arrest; 2) Quantify the frequency and impact of perceived agonal breathing on cardiac arrest diagnosis; 3) Measure the frequency with which dispatch-assisted CPR instructions can be successfully completed; and 4) Measure the impact of dispatch-assisted CPR instructions on bystander CPR and survival rates.The study will be conducted in 19 urban communities in Ontario, Canada. All 9-1-1 calls occurring in the study communities reporting out-of-hospital cardiac arrest in victims 16 years of age or older for which resuscitation was attempted will be eligible. Information will be obtained from 9-1-1 call recordings, paramedic patient care reports, base hospital records, fire medical records and hospital medical records. Victim, caller and system characteristics will be measured in the study communities before the introduction of dispatch-assisted CPR instructions (before group), during the introduction (run-in phase), and following the introduction (after group). DISCUSSION The study will obtain information essential to the development of clinical trials that will test a variety of educational approaches and delivery methods for telephone cardiopulmonary resuscitation instructions. This will be the first study in the world to clearly quantify the impact of dispatch-assisted CPR instructions on survival to hospital discharge for out-of-hospital cardiac arrest victims. TRIAL REGISTRATION ClinicalTrials.gov NCT00664443.

中文翻译：

---

对9-1-1的评估要求评估派遣辅助心肺复苏（CPR）指令的有效性：设计和方法。

背景技术心脏骤停是加拿大死亡的主要原因，院外心脏骤停的总生存率很少超过5％。旁观者心肺复苏（CPR）已显示可增加心脏骤停患者的生存率。但是，尽管进行了各种尝试，但加拿大的旁观者心肺复苏率仍然很低，很少超过15％。派遣协助的心肺复苏术指令有可能提高旁观者心肺复苏术的比率，许多加拿大城市社区现在向举报心脏骤停受害者的呼叫者提供指导。《国际紧急心血管护理指南》建议使用派遣辅助的CPR指导，但提高心脏骤停生存率的能力仍不清楚。方法/设计这项研究的总体目标是更好地了解导致成功的派遣辅助CPR指导的因素，并最终挽救更多心脏骤停患者的生命。该研究将利用前后的前瞻性队列设计来具体：1）确定9-1-1调度员正确诊断心脏骤停的能力；2）量化感觉到的早期呼吸对心脏骤停诊断的频率和影响；3）测量成功完成调度辅助的CPR指令的频率；4）评估派遣辅助CPR指令对旁观者CPR和生存率的影响。这项研究将在加拿大安大略省的19个城市社区中进行。在研究社区中发生的所有9-1-1呼叫都报告了尝试进行复苏的16岁或16岁以上患者的院外心脏骤停。将从9-1-1通话记录，护理人员的患者护理报告，基本医院记录，火灾医疗记录和医院医疗记录中获取信息。在引入调度辅助的CPR指令之前（组之前），引入过程中（试运行阶段）和引入之后（组之后），将在研究社区中测量受害者，呼叫者和系统的特征。讨论本研究将获得开展临床试验必不可少的信息，这些临床试验将测试电话心肺复苏说明的各种教育方法和传递方法。这将是世界上第一项明确量化派遣辅助CPR指令对院外心脏骤停患者住院出院生存率影响的研究。试验注册ClinicalTrials.gov NCT00664443。