911 Dispatchers Are Critical

All communities should provide CPR instructions over the telephone when someone calls 911 to request assistance for a sudden cardiac arrest. 911 call takers and dispatchers who assertively provide CPR instructions to the caller at the time of the OHCA emergency significantly increase the number of victims who receive CPR, and that saves lives. Providing dispatcher-assisted CPR instructions requires meticulous training of the defined group of 911 dispatchers and call takers, but they are an accessible group to train. Since the number of 911 call takers is a small fraction of the community’s population, this strategy provides a very effective approach for increasing the rate of bystander CPR. The EMS Medical Director can tell you more about your community’s plan to increase bystander CPR using telephone CPR instructions.

The Seattle and King County Experience

Dispatcher-assisted CPR instructions were first implemented in Seattle in 1981. The original goal was to provide CPR instructions over the telephone to bystanders while waiting for EMS help to arrive. In recent years, the instructions have evolved to consist of a very quick assessment of whether CPR is required followed by especially assertive instructions to motivate the caller to start CPR as quickly as humanly possible.

The program is successful. In 2010 in Seattle and surrounding King County, the overall rate of bystander CPR is above 50%. Among all victims who receive bystander CPR in these communities, 60% is provided by citizens who know CPR, and 40% is provided by citizens who are directed by the 911 dispatchers. The Seattle and King County programs include comprehensive quality improvement activities, with targeted training for the dispatchers and routine review of all 911 calls possibly related to OHCA. The time it takes to get CPR started as well as other benchmarks are routinely shared with the dispatchers to improve their performance.