oa Improving telephone CPR time interval at Hamad Medical Corporation Ambulance Service

Background: Hamad Medical Corporation Ambulance Service (HMCAS) Emergency Medical Dispatch Center uses protocols and processes ensuring early recognition and early telephone CPR (T-CPR) for Sudden Cardiac Arrest (SCA) reported by the public through 999 emergency lines. An audit of random sampling cases indicated that the average time to start bystander hands-on CPR varies from 5 to 7 minutes. Consequently, a quality improvement plan was designed and launched in the Emergency Dispatch Center of HMCAS for the aim of improving the average time interval from when the call is answered by an Emergency Medical Dispatcher until the caller starts hands-on CPR. The project aimed to improve the average telephone-CPR time initiation from 5 minutes in January 2018 to 3 minutes by July 2019. Methods: We adopted the American Heart Association Telephone Cardiopulmonary Resuscitation Time standards and performance benchmarks¹. A cardiac registry was implemented, audio recordings of confirmed Out of Hospital Cardiac Arrests (OHCA) received at 999 Emergency Dispatch Center were reviewed using a standardized time-stamp methodology linked with the Ambulance Service outcome data. All call takers went through training and continuous measurement of their performance levels with timely feedback. Results: Out of 214,220 received emergency calls in 2018 a total of 697 OHCA cases were audited, 332 cases received T-CPR, 231 cases met the criteria for inclusion. By July 2019, there was a reduction in Average telephone-CPR time interval from 5:38 minutes to 3:33 minutes (Figure 1). Conclusion: The implementation of T-CPR time standards and staff training was associated with improvements in the provision and timeliness of T-CPR.