9-1-1 Operators Could Save More Lives By Coaching Callers in CPR

CPR can save lives, but most bystanders are reluctant to do it. Would you be more likely to perform CPR if a 9-1-1 operator talked you through it?

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The idea of having a heart attack is scary enough, but what if no one is around to help in your hour of need? The sobering reality is that only a small fraction of people who experience cardiac arrest outside of a hospital currently survive, mainly because they don’t get cardiopulmonary resuscitation, or CPR. But more of them would  live, according to a report from the American Heart Association (AHA), if 9-1-1 dispatchers could better coach bystanders in CPR.

CPR helps to keep a person’s blood flowing, particularly to the brain, after the heart has stopped. In the few-minute window between cardiac arrest — when the heart stops — and the arrival of paramedics, maintaining some blood flow can make the difference between life and death, or between permanent brain damage and a chance at recovery.

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The AHA already advises 9-1-1 dispatchers to help bystanders provide immediate emergency assistance — first to assess whether a person has had cardiac arrest, and then, if appropriate, to administer CPR. The problem is that 9-1-1 dispatchers don’t always follow those guidelines , according to the new AHA report, published in the journal Circulation.

“It isn’t as common as you think, that you call 9-1-1 and they tell you what to do,” lead author E. Brooke Lerner said in a written statement.

What’s more, bystanders are often reluctant to perform CPR if they haven’t been trained in it before. Most fear they will do more harm than good. That’s why clear, confident instructions from the 9-1-1 dispatcher are so important.

“[T]he chances that you’re going to hurt somebody [while performing CPR] are very, very small,” Lerner says. “And if you do nothing, they’re not getting the help that’s going to save their life.”

More than 380,000 people in the U.S. are assessed for sudden cardiac arrest every year, according to the AHA.

It helps to become familiar with CPR so you feel more comfortable in case you need to help someone, says the AHA. The current CPR protocol includes only chest compressions — firm, rapid pushing on the chest — in most cases, and not the mouth-to-mouth resuscitation that was once better known. Research has found that mouth-to-mouth is often not very effective, and that people tend to feel awkward about it, which may delay CPR onset.

For most adults, only chest compressions are necessary. However, adding mouth-to-mouth — breathing support — is recommended for all infants and children, and for any adults whose cardiac arrest may be caused by asphyxia, such as drowning.

It’s certainly scary to perform CPR, especially for people who aren’t trained to do so, and, even if they are, who don’t perform the process regularly. But it is comforting to know that emergency-response dispatchers can talk you through the proper way to save someone’s life.