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document
The dispatcher assisted resuscitation trial : indirect benefits of emergency research . OBJECTIVE Conduct of emergency research under waiver of consent produces special challenges . Moreover , the act of performing research may have unintended effects , potentially beneficial or detrimental . The Dispatcher-Assisted Randomized Trial ( DART ) was designed to compare 2 types of dispatcher cardiopulmonary ( CPR ) instruction , but not intended to affect the proportion of arrest victims that received bystander CPR . We sought to determine whether odds of receiving bystander CPR were higher during DART than during the periods before and after . METHODS We conducted an observational cohort study of 8626 adults who suffered non-traumatic out-of-hospital cardiac arrest prior to emergency medical services ( EMS ) arrival in greater King County , Washington , between January 1 , 1999 , and December 31 , 2011 . Bystander CPR status was assessed through review of dispatch recordings and EMS reports to classify any bystander CPR ( any B-CPR ) , and further categorized as bystander CPR with or without dispatcher assistance ( DA-CPR and B-CPR , no DA ) . We used multivariable logistic regression to evaluate odds of B-CPR before , during , and after DART . RESULTS The proportions receiving any B-CPR were 52 % before DART ( 1817/3468 ) , 59 % during DART ( 2093/3527 ) , and 54 % after DART ( 885/1631 ) . Compared to the period before DART , odds of receiving any B-CPR were higher during DART ( OR=1.35 , 95 % CI=1.23-1.49 ) , but no different after ( OR=1.10 , 0.98-1.24 ) . Compared to the before period , odds of DA-CPR were higher during DART ( OR=1.79 , 1.59-2.02 ) but no different after ( OR=0.94 , 0.80-1.10 ) . CONCLUSIONS Odds of bystander CPR were higher during the trial , an increase related to higher likelihood of DA-CPR . The finding suggests a possible indirect community-wide benefit due to the interventional trial .
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Intervention_Educational
dispatcher cardiopulmonary ( CPR ) instruction
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Intervention_Educational
( DA-CPR and B-CPR , no DA ) .
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Outcome_Other
indirect benefits
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Outcome_Physical
dispatcher cardiopulmonary ( CPR ) instruction
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Outcome_Physical
bystander CPR
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Outcome_Physical
Bystander CPR status
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Outcome_Physical
bystander CPR ( any B-CPR )
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Outcome_Physical
bystander CPR with or without dispatcher assistance ( DA-CPR and B-CPR , no DA )
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Outcome_Physical
B-CPR
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Outcome_Physical
B-CPR
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Outcome_Physical
receiving any B-CPR
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Outcome_Physical
DA-CPR
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Outcome_Physical
Odds of bystander CPR
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Outcome_Other
DA-CPR