Association between the centralization of dispatch centers and dispatcher-assisted cardiopulmonary resuscitation programs: A natural experimental study

Interaction between Bystander Sex and Patient Sex in Bystander Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrests

BACKGROUND

Bystander cardiopulmonary resuscitation (CPR) is a critical factor in improving out-of-hospital cardiac arrest (OHCA) survival. The aim of this study was to investigate the interaction effect of bystander sex and patient sex on the provision of bystander CPR.

METHODS

This was a retrospective cohort study using national OHCA registry in Korea. The inclusion criteria were adult bystander-witnessed OHCA patients with presumed cardiac etiology from January 2016 to December 2020. The primary outcome was the provision of bystander CPR. Multivariable logistic regression and interaction analysis were conducted to evaluate the impact of bystander sex on bystander CPR provision based on patient sex.

RESULTS

The study included 24,919 patients with OHCA, 58.2% with male-bystanders and 41.8% with female-bystanders. Female bystanders were less likely to perform bystander CPR than male bystanders (68.0% vs. 78.8%, adjusted OR (95% CI): 0.62 (0.58-0.66)). Among patients with CPR-trained bystanders, female bystanders had lower odds of bystander CPR (0.85 (0.73-0.97)). In the interaction analysis between bystander and patient sex, a significant difference was observed in the likelihood of bystander CPR according to the patient sex. Female bystanders had lower odds of bystander CPR than male bystanders for male patients (0.47 (0.43-0.50)). However, there were no significant differences between male and female bystanders for female patients (0.91 (0.88-1.07)).

CONCLUSION

Female bystanders have a lower likelihood of providing bystander CPR than male bystanders. Additionally, an interaction was observed between bystander sex and patient sex in the providing bystander CPR, with the association being more pronounced in male OHCA patients.

Effect of team-based cardiopulmonary resuscitation training for emergency medical service providers on pre-hospital return of spontaneous circulation in out-of-hospital cardiac arrest patients

OBJECTIVE

This study aimed to assess whether team-based cardiopulmonary resuscitation (CPR) training for emergency medical service (EMS) providers improved the pre-hospital return of spontaneous circulation (ROSC) rates of non-traumatic adult out-of-hospital cardiac arrest (OHCA) patients.

METHODS

This was a before-and-after study an evaluating educational intervention for community EMS providers, which was conducted in Gyeonggi province, South Korea. Team-based CPR training was conducted from January to March 2016 for every level 1 and level 2 EMS provider in the study area. Non-traumatic EMS treated OHCA patients from July to December 2015 and from July to December 2016 were enrolled and used for the analysis. The primary outcome was pre-hospital ROSC rates before and after the training period. A multivariable logistic regression model with an interaction term (period × dispatch type) was used to determine the adjusted odds ratios (aORs) according to the dispatch type (single vs. multi-tiered).

RESULTS

Of the 2125 OHCA cases included, 1072 (50.4%) and 1053 (49.6%) were categorized in the before- and after-training groups, respectively, and the pre-hospital ROSC rates were 6.6% and 12.6%, respectively. In the multivariable logistic regression analysis, the aOR for pre-hospital ROSC was 2.07 (95% CI, 1.32-3.25) in the after-training period. In the interaction model (period × type of dispatch), the aORs for pre-hospital ROSC were 2.00 (95% CI, 1.01-3.98) and 2.13 (95% CI, 1.20-3.79) in the single- and multi-tiered dispatch groups, respectively, during the after-training period.

CONCLUSION

Team-based CPR training for EMS providers in a large community EMS system improved the pre-hospital ROSC rates of OHCA patients.