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Development of a Performance Assessment Scale for Simulated Dispatcher-Assisted Cardiopulmonary Resuscitation (Telephone-CPR): A Multi-Center Randomized Simulation-Based Clinical Trial

Published online by Cambridge University Press:  23 July 2021

Daniel Aiham Ghazali Open the ORCID record for Daniel Aiham Ghazali [Opens in a new window] ,
Caroline Delaire ,
Emmanuel Blottiaux ,
Jean-Yves Lardeur ,
Daniel Jost Open the ORCID record for Daniel Jost [Opens in a new window] ,
Mathieu Violeau ,
Cyril Breque  and
Denis Oriot
Daniel Aiham Ghazali*
Affiliation:
Department of Emergency Medicine and EMS, University Hospital Center, Bichat, Paris, France Simulation center Ilumens, University of Paris, Paris, France
Caroline Delaire
Affiliation:
Department of EMS, University Hospital Center, Poitiers, France
Emmanuel Blottiaux
Affiliation:
Department of Emergency Medicine, University Hospital of Rennes, Rennes, France Paris Fire Brigade Emergency Department, Pairs, France
Jean-Yves Lardeur
Affiliation:
Department of Emergency Medicine, Hospital of Chatellerault, Chatellerault, France
Daniel Jost
Affiliation:
Paris Fire Brigade Emergency Department, Pairs, France
Mathieu Violeau
Affiliation:
Department of Emergency Medicine, Hospital of Niort, Niort, France
Cyril Breque
Affiliation:
Simulation Center, Faculty of Medicine of Poitiers, Poitiers, France
Denis Oriot
Affiliation:
Simulation Center, Faculty of Medicine of Poitiers, Poitiers, France Department of Pediatric Emergency Medicine, University Hospital Center, Poitiers, France
*
Correspondence: Daniel Aiham Ghazali, MD, PhD Emergency Department and Emergency Medical Service University Hospital of Bichat 46 rue Henri Huchard, 75018 Paris, France E-mail: aiham@hotmail.com
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Abstract

Introduction:

Dispatchers should be trained to interrogate bystanders with strict protocols to elicit information focused on recognizing cardiac arrest and should provide telephone cardiopulmonary resuscitation (CPR) instructions in all cases of suspected cardiac arrest. While an objective assessment of training outcomes is needed, there is no performance assessment scale for simulated dispatcher-assisted CPR.

Study Objective:

The aim of the study was to create a valid and reliable performance assessment scale for simulated dispatcher-assisted CPR.

Methods:

In this prospective, randomized, controlled, multi-centric simulation-based trial (registration number TCTR20210130002), the scale was developed according to the European Resuscitation Council (ERC) and American Heart Association (AHA) Guidelines 2015 and revised by experts. The performance of 48 dispatchers’ telephone-CPR and of 48 bystanders carrying out CPR on a manikin was assessed by two independent evaluators using the scale and using a SkillReporter (PC) software to provide CPR objective performance. Continuous variables were described as mean (SD) and categorical variables as numbers and percentage (%). Comparative analysis between two groups used a Student t-test or a non-parametric test of Mann-Whitney. The internal structure of the scale was evaluated, including internal consistency using α Cronbach coefficient, and reproducibility using intraclass correlation coefficient (ICC) and linear correlation coefficient (R2) calculation.

Results:

The scale included three different parts: two sections for dispatchers’ (32 items) and bystanders’ CPR performance (15 items) assessment, and a third part recording times. There was excellent internal consistency (α Cronbach coefficient = 0.77) and reproducibility (ICC = 0.93; R² = 0.86). For dispatchers’ performance assessment, α Cronbach coefficient = 0.76; ICC = 0.91; R2 = 0.84. For bystanders’ performance assessment, α Cronbach coefficient = 0.75; ICC = 0.93; R2 = 0.87. Reproducibility was excellent for nine items, good for 19 items, and moderate for 19 items. No item had poor reproducibility. There was no significant difference between dispatch doctors’ and medical dispatch assistants’ performances (33.0 [SD = 4.7] versus 32.3 [SD = 3.2] out of 52, respectively; P = .70) or between trained and untrained bystanders to follow the instructions (14.3 [SD = 2.0] versus 13.9 [SD = 1.8], respectively; P = .64). Objective performance (%) was significantly higher for trained bystanders than for untrained bystanders (67.4 [SD = 14.5] versus 50.6 [SD = 19.3], respectively; P = .03).

Conclusion:

The scale was valid and reliable to assess performance for simulated dispatcher-assisted CPR. To the authors’ knowledge, no other valid performance tool currently exists. It could be used in simulated telephone-CPR training programs to improve performance.

Keywords

bystandercardiopulmonary resuscitationdispatchersimulationtelephone scale
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 36 , Issue 5 , October 2021 , pp. 561 - 569
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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References

Sasson, C, Rogers, MA, Dahl, J, et al. Predictors of survival from out-of-hospital cardiac arrest: a systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2010;3(1):63–81.CrossRefGoogle ScholarPubMed
Baekgaard, J, Viereck, S, Moller, T, et al. The effects of public access defibrillation on survival after out-of-hospital cardiac arrest: a systematic review of observational studies. Circulation. 2017;136(10):954–965.CrossRefGoogle ScholarPubMed
European Resuscitation Council Guidelines for Resuscitation 2015. Resuscitation. 2015;95:1–311.CrossRefGoogle Scholar
American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science. Circulation. 2015;132(Suppl 2):S313–S589.CrossRefGoogle Scholar
Perkinsa, GD, Handley, AJ, Koster, RW, et al. European Resuscitation Council Guidelines for Resuscitation 2015: Section 2. Adult Basic Life Support and automated external defibrillation. Resuscitation. 2015;95:81–99.CrossRefGoogle Scholar
Travers, S, Jost, D, Gillard, Y, et al. Out-of-hospital cardiac arrest phone detection: those who most need chest compressions are the most difficult to recognize. Resuscitation. 2014;85(12):1720–1725.CrossRefGoogle ScholarPubMed
Stipulante, S, Tubes, R, El Fassi, M, et al. Implementation of the ALERT algorithm, a new dispatcher-assisted telephone cardiopulmonary resuscitation protocol, in non-Advanced Medical Priority Dispatch System (AMPDS) Emergency Medical Services centers. Resuscitation. 2014;85(2):177–181.CrossRefGoogle Scholar
Castren, M, Kuisma, M, Serlachius, J, et al. Do health care professionals report sudden cardiac arrest better than laymen? Resuscitation. 2001;51(3):265–268.CrossRefGoogle ScholarPubMed
Dami, F, Fuchs, V, Praz, L, et al. Introducing systematic dispatcher-assisted cardiopulmonary resuscitation (telephone-CPR) in a non-Advanced Medical Priority Dispatch System (AMPDS): implementation process and costs. Resuscitation. 2010;81(7):848–852.CrossRefGoogle Scholar
Seyed Bagheri, SM, Sadeghi, T, Kazemi, M, et al. Dispatcher-assisted bystander cardiopulmonary resuscitation (telephone-CPR) and outcomes after out-of-hospital cardiac arrest. Bull Emerg Trauma. 2019;7(3):307–313.CrossRefGoogle ScholarPubMed
Bohm, K, Vaillancourt, C, Charette, M L, et al. In patients with out-of-hospital cardiac arrest, does the provision of dispatch cardiopulmonary resuscitation instructions as opposed to no instructions improve outcome: a systematic review of the literature. Resuscitation. 2011;82(12):1490–1495.CrossRefGoogle ScholarPubMed
Tanaka, Y, Taniguchi, J, Wato, Y, et al. The continuous quality improvement project for telephone-assisted instruction of cardiopulmonary resuscitation increased the incidence of bystander CPR and improved the outcomes of out-of-hospital cardiac arrests. Resuscitation. 2012;83(10):1235–1241.CrossRefGoogle ScholarPubMed
Rea, TD, Eisenberg, MS, Culley, LL, et al. Dispatcher-assisted cardiopulmonary resuscitation and survival in cardiac arrest. Circulation. 2001;104(21):2513–2516.CrossRefGoogle ScholarPubMed
Ghuysen, A, Collas, D, Stipulante, S, et al. Dispatcher-assisted telephone cardiopulmonary resuscitation using a French-language compression-only protocol in volunteers with or without prior life support training: a randomized trial. Resuscitation. 2011;82(1):57–63.CrossRefGoogle ScholarPubMed
Downing, SM. Validity: on meaningful interpretation of assessment data. Med Educ. 2003;37(9):830–837.CrossRefGoogle ScholarPubMed
Deakin, CD, Cheung, S, Petley, GW, et al. Assessment of the quality of cardiopulmonary resuscitation following modification of a standard telephone-directed protocol. Resuscitation. 2007;72(3):436–443.CrossRefGoogle ScholarPubMed
Mirza, M, Brown, TB, Saini, D, et al. Instructions to « push as hard as you can » improve average chest compression depth in dispatcher-assisted cardiopulmonary resuscitation. Resuscitation. 2008;79(1):97–102.CrossRefGoogle Scholar
Ghazali, DA, Richard, A, Chaudet, A, et al. Profile and motivation of patients consulting in emergency departments while not requiring such a level of care. Int J Environ Res Public Health. 2019;16(22):4431.CrossRefGoogle Scholar
Wadgave, U, Khairnar, MR. Parametric tests for Likert scale: for and against. Asian J Psychiatr. 2016;24:67–68.CrossRefGoogle ScholarPubMed
Bajaj, K, Meguerdichian, M, Thoma, B, et al. The PEARLS Healthcare Debriefing Tool. Acad Med. 2018;93(2):336.CrossRefGoogle ScholarPubMed
Whitfield, RH, Newcombe, RG, Woolard, M. Reliability of the Cardiff test of basic life support and automated external defibrillation version 3.1. Resuscitation. 2003;59:291–314.CrossRefGoogle ScholarPubMed
Rivera-Tovar, LA, Jones, RT. Effect of elaboration on the acquisition and maintenance of cardiopulmonary resuscitation. J Pediatr Psychol. 1990;15(1):123–128.CrossRefGoogle ScholarPubMed
Peterson, RA. A meta-analysis of Cronbach’s Coefficient Alpha. J Consum Res. 1994;21(2):381–391.CrossRefGoogle Scholar
Koo, TK, Li, MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15(2):155–163.CrossRefGoogle ScholarPubMed
Lester, CA, Morgan, CL, Donnelly, PD, et al. Assessing with CARE: an innovative method of testing the approach and casualty assessment components of basic life support using video recording. Resuscitation. 1997;34(1):43–49.CrossRefGoogle ScholarPubMed
Donnelly, PD, Lester, CA, Morgan, CL, et al. Evaluating CPR performance in basic life support: the VIDRAP protocol. Resuscitation. 1998;36(1):51–57.CrossRefGoogle ScholarPubMed
Vanderschmidt, H, Burnap, TK, Thwaites, JK. Evaluation of a cardiopulmonary resuscitation course for secondary schools. Med Care. 1975;13(9):763–774.CrossRefGoogle ScholarPubMed
Sigaux, A. Evaluation de la conformité du conseil téléphonique au centre 15 en cas d’arrêt cardiaque. Ann Fr Med Urgence. 2014;4:11–17.CrossRefGoogle Scholar
Brown, TB, Dias, JA, Saini, D, et al. Relationship between knowledge of cardiopulmonary resuscitation guidelines and performance. Resuscitation. 2006;69(2):253–261.CrossRefGoogle ScholarPubMed
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