Dispatcher-Activated Neighborhood Access Defibrillation and Cardiopulmonary Resuscitation

Population Based Intervention Trial of Dispatcher-Activated Neighborhood Access Defibrillation and Cardiopulmonary Resuscitation

Korean Center for Disease Control and Prevention, Seoul Metropolitan Government Health and Welfare Office, Seoul Metropolitan Fire and Disaster Headquater, Korea Association for Safety Community

The hypothesis of this study is Dispatcher-Activated Neighborhood Access Defibrillation and Cardiopulmonary Resuscitation (NAD-CPR) would improve survival of out-of-hospital cardiac arrest (OHCA).

Out-of-hospital cardiac arrest (OHCA) is a major health problem, occurring in about 1 in 1,500 adults in the developed countries each year. Although layperson CPR and defibrillation are crucial components of chain of survival, layperson CPR rate and it's quality is low and public-access defibrillation (PAD) program is not cost-effective.If trained bystanders can know the information of occurrence of OHCA and nearest place for automated external defibrillator (AED) at the same time by dispatch center, these neighborhoods could run and give high quality CPR and early defibrillation. If this protocol ,Dispatcher-Activated Neighborhood Access Defibrillation and Cardiopulmonary Resuscitation(NAD-CPR), is introduced to community, it may improve survival of OHCA.

When dispatcher detects a patient with OHCA, the dispatcher activates trained neighborhoods by informing events nearby using short message service via cellular phone. The neighborhood within geographically accessible area who could perform effective CPR and defibrillation would be alerted with event of OHCA and the nearest AED.

When dispatcher detects OHCA, they instruct the caller with CPR instructions. This is conventional dispatcher assisted CPR performed in Seoul.

When Dispatcher detects OHCA, short message service (SMS)about the OHCA event and information about the location of nearest AED is sent to trained laypersons within geographically accessible area.

we compared the survival to discharge rate between before intervention period and intervention period. Survival to discharge checked at the discharge point of hospital.

we compared the Pre-hospital return of spontaneous circulation (ROSC) rate between before intervention period and intervention period.

Cerebral performance category 1 or 2 is defined as good neurological recovery. we compared the good neurological recovery rate between before intervention period and intervention period.

Inclusion Criteria: all OHCA with presumed cardiac etiology more than 15 years old assessed by emergency medical service (EMS) providers dispatched by dispatch center dispatcher detected OHCA patients Exclusion Criteria: OHCA with non-cardiac etiology prolonged cardiac arrest with a suspected duration more than 30 minutes cases with rigor mortis or rivor mortis, decapitated or decomposed body Non detected cases by dispatcher

Lee SY, Shin SD, Lee YJ, Song KJ, Hong KJ, Ro YS, Lee EJ, Kong SY. Text message alert system and resuscitation outcomes after out-of-hospital cardiac arrest: A before-and-after population-based study. Resuscitation. 2019 May;138:198-207. doi: 10.1016/j.resuscitation.2019.01.045. Epub 2019 Mar 19.