Top Things to Know: Telecommunicator Cardiopulmonary Resuscitation
Published: February 24, 2020
- Each year, an estimated 350,000 people experience cardiac arrest in the US in out-of-hospital environments. Successful resuscitation of cardiac arrest victims requires immediate response to improve their chance of survival.
- Early lay rescuer CPR is associated, on average, with an approximate 2-fold increase in the chances of survival after out-of-hospital cardiac arrest (OHCA). Compared with no lay rescuer CPR, telecommunicator CPR (T-CPR) is associated with a greater likelihood of survival after OHCA.
- As the true first responder, the telecommunicator must partner with a caller to quickly identify a person experiencing a cardiac arrest and provide T-CPR instructions and rapidly dispatch the appropriate medical response.
- Previous statements from the International Liaison Committee on Resuscitation (ILCOR) and AHA have addressed improved outcomes from T-CPR to increase lay rescuer CPR and improve OHCA outcomes. This policy statement outlines the components needed to implement a science-based T-CPR program within a community.
- An effective T-CPR program depends on several important operational commitments by the emergency response system including:
- Providing a high-quality, effective T-CPR program that includes measurement and performance goals.
- Providing initial and ongoing education in T-CPR for all telecommunicators.
- Conducting effective and continuous QI.
- Connecting to an EMS agency.
- Designating a medical director.
- Recognizing outstanding performance.
- Effective T-CPR depends on well-prepared professionals trained to elicit information quickly, interpret that information, and provide direction.
- A high-quality T-CPR program must utilize a continuous quality improvement program to shape and implement recommendations. Standardized quality metrics are imperative to a robust QI program. This policy statement includes five key performance measures, including time interval standards, for a successful T-CPR program.
- Best practice calls for involving an active, engaged physician to provide qualified oversight of an emergency medical dispatch system, including T-CPR and other prearrival instructions. The engaged physician should also help implement QI practices related to these and other components of the system of care.
- Regardless of experience or background, all telecommunicators should receive two to three hours of annual continuing medical education specific to T-CPR and cardiac arrest to ensure they are up to date with contemporary guidelines.
- With the oversight of a physician medical director, T-CPR provides CPR education “just in time,” ensuring that responding lay rescuers can provide appropriate CPR, improving the chances of survival for OHCA victims.
Citation
Kurz MC, Bobrow BJ, Buckingham J, Cabanas JG, Eisenberg M, Fromm P, Panczyk MJ, Rea T, Seaman K, Vaillancourt C, on behalf of the American Heart Association Advocacy Coordinating Committee. Telecommunicator cardiopulmonary resuscitation: a policy statement from the American Heart Association [published online ahead of print February 24, 2020]. Circulation. doi: 10.1161/CIR.0000000000000744.