CPR | AHA Develops Standards To Improve 911 Dispatcher-Assisted CPR

Public feedback is being sought for draft standards set by the American Heart Association to help 911 dispatchers walk callers through CPR during a suspected cardiac arrest.

The organization will collect comments until Nov. 16 and use the input to encourage emergency communications and dispatch centers nationwide to adopt the standards.

“It’s important to get public comment because there are numerous, important stakeholders in this space,” said Michael C. Kurz, M.D., an associate professor of emergency medicine at the University of Alabama at Birmingham and chair of the AHA’s Telephone-CPR task force. “

With the variety of dispatch and EMS systems, we need to know how these recommendations will affect cardiac arrest care.”

The AHA wants to know how the standards will affect stakeholders and whether they’re realistic, he said.

Dispatchers and callers form a team that can “literally snatch life from the jaws of death” during a cardiac arrest, according to the AHA. More than 350,000 Americans have a cardiac arrest outside a hospital each year, and only 12 percent survive.

Among nearly 2,000 U.S. dispatch centers surveyed in 2010, only about half provided CPR instructions by phone, research has found.

Immediate CPR can double or triple a cardiac arrest victim’s chances of survival, and dispatcher-assisted CPR could double the number of cardiac arrest patients who get CPR from bystanders. Currently, less than half of those who have a cardiac arrest outside a hospital get bystander CPR.

For more than a decade, the AHA has recommended 911 dispatchers help callers identify a cardiac arrest and walk them through CPR. The availability of mobile phones allows more people to call 911 quickly, and guidelines released last year recommend callers use the speaker phone function to more easily follow along with dispatcher instructions.

Among the new draft recommendations:

Emergency communications center and dispatch center directors commit to effective dispatcher-provided CPR.

Dispatchers train to give effective CPR instructions by phone, and retrain to maintain and update skills.

Implement quality improvement efforts that include analysis of all calls with confirmed cardiac arrests and resuscitation attempts.

Evaluate dispatcher performance based on measures such as the percentage of cardiac arrest cases correctly identified; the percentage of victims who receive dispatcher-assisted CPR; and how long it takes for the dispatcher to recognize a cardiac arrest and how long it takes for CPR to begin.

Dispatcher CPR has the highest yield, in terms of lives saved, for communities that implement it, Kurz said. “Even if someone calls 911 and has never been trained in CPR, in a period of less than 30 seconds, [a dispatcher] can provide just-in-time education.”

“The long-term goal,” he said, “is that every cardiac arrest would receive telephone instructions to perform bystander CPR.”

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