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Emerg Med J. 2015 Apr;32(4):314-7. doi: 10.1136/emermed-2013-203112. Epub 2014 Jan 8.

Abnormal breathing of sudden cardiac arrest victims described by laypersons and its association with emergency medical service dispatcher-assisted cardiopulmonary resuscitation instruction.

Author information

1
Department of Emergency and Critical Care Medicine, Nara Medical University, Kashihara, Nara, Japan.
2
Department of Neurosurgery, Nara Saiseikai Gose Hospital, Gose, Nara, Japan.
3
Department of Health Service, Kyoto University Health Service, Kyoto, Kyoto, Japan.
4
Department of General Medicine, Nara Medical University, Kashihara, Nara, Japan.
5
Department of Community Health and Epidemiology, Nara Medical University, Kashihara, Nara, Japan.

Abstract

BACKGROUND:

Current guidelines for cardiopulmonary resuscitation (CPR) emphasise that emergency medical service (EMS) dispatchers should identify sudden cardiac arrest (CA) with abnormal breathing and assist lay rescuers performing CPR. However, lay rescuers description of abnormal breathing may be inconsistent, and it is unclear how EMS dispatchers provide instruction for CPR based on the breathing status of the CA victims described by laypersons.

METHODS AND RESULTS:

To investigate the incidence of abnormal breathing and the association between the EMS dispatcher-assisted CPR instruction and layperson CPR, we retrospectively analysed 283 witnessed CA cases whose information regarding breathing status of CA victims was available from population-based prospective cohort data. In 169 cases (59.7%), laypersons described that the CA victims were breathing in various ways, and that the victims were 'not breathing' in 114 cases (40.3%). Victims described as breathing in various ways were provided EMS dispatch-instruction for CPR less frequently than victims described as 'not breathing' (27.8% (47/169) vs 84.2% (96/114); p<0.001). Multivariate logistic regression showed that EMS dispatch-instruction for CPR was associated significantly with layperson CPR (adjusted OR, 11.0; 95% CI, 5.72 to 21.2).

CONCLUSIONS:

This population-based study indicates that 60% of CA victims showed agonal respiration, which was described as breathing in various ways at the time of EMS call. Although EMS dispatch-instruction was associated significantly with an increase in layperson CPR, abnormal breathing was associated with a much lower rate of CPR instruction and, in turn, was related to a much lower rate of bystander CPR.

KEYWORDS:

cardiopulmonary resuscitation; emergency medical services

PMID:
24401986
PMCID:
PMC4392227
DOI:
10.1136/emermed-2013-203112
[Indexed for MEDLINE]
Free PMC Article

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