Video analysis of dispatcher-rescuer teamwork-Effects on CPR technique and performance

Objective: We wanted to study the effect of continuous dispatcher communication on CPR technique and performance during 10min of simulated cardiac arrest.

Method: We reviewed video recordings and manikin data from 30 CPR trained lay people who where left alone in a simulated cardiac arrest situation with a manikin in a home-like environment (in a small, confined kitchen with the disturbing noise of a radio). CPR was performed for 10min with continuous telephone instructions via speaker function from a dispatcher. The dispatcher was blinded for CPR performance and video. Dispatcher communication, compression technique and ventilation technique was scored as accomplished or failed in the 1st and 10th minute.

Results: 29/30 rescuers were able to hear instructions, answer questions from the dispatcher and perform CPR in parallel. Rescuer position beside manikin was initially correct for 13/30, improving to 21/30 (p=0.008). Compression technique was adequate for the whole episode, with an insignificant trend for improvement; 29 to 30/30 using straight arms, 28 to 30/30 in a vertical position over chest and 24 to 27/30 counting loudly. 17/29 placed their hands between the nipples initially, improving to 24/29 (p=0.065). Mean compression rate improved from 84 to 101min(-1) (p<0.001), and compression depth maintained adequate (43 to 42mm). Initially, 17/29 used chin-lift manoeuvre, 14/30 used head-tilt and 19/29 used nose pinch to manage open airways, compared to 18, 20 and 22/29 (ns) in the 10th minute, respectively. Successful delivery of ventilation improved from 13/30 to 23/30 (p=0.006).

Conclusion: Bystander and dispatcher can communicate successfully during ongoing CPR using a telephone with speaker function. CPR technique and quality improved or did not change over 10min with continuous dispatcher assistance. These results suggest a potential for improved bystander CPR using rescuer-dispatcher teamwork.