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Leben retten durch leitstellengestützte Reanimation

Welche telefonische Anleitung ist sinnvoll?

Saving lives with dispatcher-assisted resuscitation

Importance of effective telephone instruction

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Medizinische Klinik - Intensivmedizin und Notfallmedizin Aims and scope Submit manuscript

Zusammenfassung

Hintergund

Die Überlebensraten nach einem plötzlichen Herz-Kreislauf-Stillstand könnten durch sofortiges Einleiten der Wiederbelebungsmaßnahmen gesteigert werden, wenn es gelingt Zeugen bis zum Eintreffen der Rettungskräfte zur Herzdruckmassage zu motivieren. Dieses sollte durch den Notruf annehmenden Disponenten der Leitstelle geschehen.

Ziel der Arbeit

Es soll geklärt werden, ob die Zeit zwischen Notrufeingang und Beginn der Reanimation durch ein vereinfachtes Protokoll verkürzt werden kann und ob es einen Zusammenhang zwischen Intensität des telefonischen Kontaktes und einer Verbesserung der Ergebnisse gibt.

Material und Methoden

Bei bekannter vorliegender Bewusstlosigkeit erhielt Gruppe 1 (45 Probanden) durch den Disponenten eine kurze telefonische Anleitung zur Herz-Lungen-Wiederbelebung, wobei der Disponent so lange am Telefon blieb, bis der Rettungsdienst eintraf. Bei Gruppe 2 (45 Probanden) wurde das Telefonat nach identischer Anleitung sofort beendet. Gruppe 3 (29 Probanden) erhielt ausschließlich den Hinweis, mit Herz-Lungen- Wiederbelebungsmaßnahmen zu beginnen.

Ergebnisse

Die Probanden in Gruppen 1 begannen im Mittel nach 68,0 ± 33,5 s mit den Reanimationsmaßnahmen, in Gruppe 2 nach 68,3 ± 25,2 s und in Gruppe 3 nach 64,9 ± 34,4 s. Die erreichte mittlere Kompressionsfrequenz lag in Gruppe 1 bei 98,3/min, in Gruppe 2 bei 84,8/min und in Gruppe 3 bei 85,2/min. In Gruppe 1 erreichten 47,8 %, in Gruppe 2 44,2 % und in Gruppe 3 30,2 % der Probanden die korrekte Drucktiefe. Die Probanden fühlten sich in allen Gruppen gut betreut. Die Frage, ob Handlungsanweisungen vermisst wurden, wurde von 70 der 90 Probanden verneint.

Diskussion

In den Gruppen ergeben sich keine signifikanten Unterschiede in den Zielvariablen. Demnach werden Ersthelfer schon nach kurzer telefonischer Anleitung durch den Leitstellendispontenten bzw. allein durch den Hinweis, mit einer Herz-Lungen- Wiederbelebung zu beginnen, zur Hilfeleistung motiviert. Eine kontinuierliche telefonische Betreuung scheint nicht erforderlich zu sein.

Abstract

Background

Survival rates after sudden cardiac arrest could be increased if bystanders could be encouraged to perform CPR until emergency services arrive. This should be initiated by the dispatcher at the emergency control facility who receives the call. For the first time the ERC guidelines of 2010 included instructions to be given to untrained rescuers by the dispatcher. Rapid recognition of cardiac arrest and initiation of emergency measures is assured by means of specific training for the dispatchers.

Aim

The aim of this investigation was to determine whether the time between an emergency call and beginning of cardiopulmonary resuscitation (CPR) could be shortened using a simple protocol and whether a relationship exists between the intensity of phone contact between dispatcher and caller and if this improves the results.

Materials and methods

In known cases of unconsciousness, group 1 (45 persons) received short CPR instructions via the phone, where the dispatcher was on the phone for continuous advice until emergency services arrived. Group 2 (45 persons) received identical phone instructions like group 1, but the phone call was terminated by the dispatcher after the information was provided. Group 3 (29 persons) only received instructions to start CPR.

Results

On average, all test persons in group 1 started reanimation after 68.0 ± 33.5 s, in group 2 after 68.3 ± 25.2 s, and in group 3 after 64.9 ± 34.4 s. The compression frequency on average was 98.3/min in group 1, 84.8/min in group 2, and 85.2/min in group 3; therefore, all groups reached an average frequency of > 80/min. The correct compression depth was achieved by 47.8 % of test persons in group 1, by 44.2 % in group 2, and by 30.2 % in group 3. All volunteers felt well supported. Of the 90 people, 70 did not feel that they were missing instructions.

Discussion

There were no significant differences between the groups regarding the target variables. The results show that already extremely short instructions or advice by the dispatcher to start CPR is sufficient to encourage bystanders to give assistance in an emergency. Continuous support over the phone does not appear to be necessary.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. C. Kloppe, T. Maaßen, U. Bösader und C. Hanefeld geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Medizinische Klinik III, Katholisches Klinikum Bochum, Bleichstr. 15, 44787, Bochum, Deutschland

    C. Kloppe, T. Maaßen & C. Hanefeld

  2. Feuerwehr und Rettungsdienst der Stadt Bochum, -, -

    U. Bösader

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  1. C. Kloppe
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  2. T. Maaßen
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  3. U. Bösader
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  4. C. Hanefeld
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Correspondence to C. Kloppe.

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Kloppe, C., Maaßen, T., Bösader, U. et al. Leben retten durch leitstellengestützte Reanimation. Med Klin Intensivmed Notfmed 109, 614–620 (2014). https://doi.org/10.1007/s00063-014-0381-0

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  • DOI: https://doi.org/10.1007/s00063-014-0381-0

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