Chest Compressions Only CPR Instructions Suggested for 9 1 1 Dispatchers
July 2005, MERGINET—Emergency medical dispatchers—the early link to emergency interventions—provide instructions to laypersons that can alter the course of the emergency. Dispatcher-CPR instructions traditionally included the standard ventilation and chest compression techniques taught in CPR classes, but researchers in the May issue of Resuscitation noted “expeditious compliance with these multiple directives can be extremely difficult, especially when (undemonstrated) instructions are provided, for the first time, over the telephone, to a frightened person in a stressful situation.”
To address this problem, the
National Academies of Emergency Dispatch (NAED) Council of Standards developed
a modified telephone CPR protocol to support the use of chest-compressions-only
CPR instructions (CCOIs) by emergency medical
dispatchers. The NAED is the only organization setting standards for emergency
medical dispatchers, noted Jeff J. Clawson, MD, of Medical Priority
After testing draft protocols
in numerous cities in the
The new protocols include:
• Instructing trained lay rescuers to continue performing CPR per their training.
• In adult cases of sudden
cardiac arrest, instructing rescuers untrained in, unsure of, or unwilling to
give mouth-to-mouth ventilation to perform consecutive chest compressions for
approximately four minutes (400 compressions), followed by ventilations between
each subsequent 100 chest compressions, until
• Providing current rescue breathing/CPR instructions for children and for adult cases involving probable respiratory or traumatic causes, such as choking, drowning, inhalation of noxious fumes, strangulation, or other trauma.
The NAED Council of Standards
noted these recommendations are “based on the best available information and
reasonable inferences from physiological and experimental data.” They cite much
of the same research that prompted Austin/Travis County
Noting the need to allow time for retraining in the use of the new protocol, the NAED supports the previous standard CPR protocol for one year; therefore no adequate oversight data is currently available. But the Council believes that medical direction
and quality assurance are key components of protocol implementation and use, and supports ongoing oversight.