Dispatcher-assisted cardiopulmonary resuscitation. An evaluation of efficacy amongst elderly

Bystander cardiopulmonary resuscitation (CPR) increases survival rates. The largest group of cardiac arrest patients are men over the age of 60 in the home, and the most probable potential CPR provider is an older woman who is not likely to have received CPR training. One method to increase the percentage of bystander-initiated CPR in this setting is for CPR instruction to be provided by nurse dispatchers via telephone. Two male and 18 female volunteers with a median age of 78 years and no previous CPR experience performed 9 min of telephone assisted CPR on a manikin. They were randomised to receive telephone instructions in chest compressions alone or standard CPR including mouth-to-mouth ventilation. Variables were registered by a recording manikin, visual observations, and video and audiotape recordings. The median period from dispatcher contact until continuous CPR was significantly longer for standard instructions than for compression only, 4.9 versus 3.4 min, and fewer chest compressions were provided during the 9 min test period, median 124 versus 334 compressions. In both groups the overall CPR performance was of very poor quality, and unlikely to have affected outcome in a real situation. Other telephone assisted CPR scripts should be tested in this potential bystander group. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.