Dispatcher-assisted CPR for OHCA: AHA issues focused update

  • Panchal AR & al.
  • Circulation
  • 14 nov. 2019

  • de Jenny Blair, MD
  • Clinical Essentials
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Takeaway

  • For patients with out-of-hospital cardiac arrest (OHCA), dispatcher-assisted CPR (DA-CPR) correlates with better outcomes and is recommended.
  • Transporting resuscitated patients to specialty cardiac arrest centers (CACs) is reasonable if it can be done in a timely fashion.

Why this matters

  • DA-CPR may empower more bystanders to render aid to OHCA victims.
  • CACs are not everywhere locally available, presenting prehospital personnel with a pivotal decision about transport.

Description

  • Update of part 4 of 2015 American Heart Association (AHA) guidelines.
  • Recommendations relate to DA-CPR and CACs. 

Key details

  • The availability of DA-CPR correlates with better clinical outcomes in OHCA.
  • Emergency centers should empower dispatchers to help bystanders begin CPR for adults with suspected OHCA. 
    • Strong recommendation despite very low certainty of effect.
    • Group “also believes there is merit in dispatchers…continuing to coach callers in delivering high-quality CPR until the arrival of professional rescuers and their assumption of patient care.”
  • When comprehensive postarrest care is not available at nearby hospitals, timely transport of resuscitated patients to specialized CACs is reasonable.
    • Moderate-strength recommendation based on limited data. 
    • “Although supportive evidence for comprehensive post-cardiac arrest interventions remains largely observational...they may nonetheless represent a logical clinical link between successful resuscitation and ultimate survival.”