King County emergency dispatchers use a basic two-question format to determine whether CPR should be started: Is the person conscious? Is the person breathing normally?
"If the answers are 'no,' the dispatcher tells the caller to 'get the victim on a hard surface, on his back, bare the chest, put the hands in the center of the chest right between the nipples and then start compressions of one to two inches, counting aloud,'" Rea said. The dispatcher counts along with the CPR giver, and the routine continues until the emergency response team arrives.
It can end sooner if the person getting CPR regains consciousness and tells the rescuer to stop.
King County is unusually well organized to handle cardiac emergencies, Sayre said. "My experience is that in many places, the 911 center is almost too polite," he said. "In communities like King County, call-takers are aggressive about telling callers how to do CPR."
There often is uncertainty at the caller's end of the telephone encounter, Sayre said. "I know there can be hesitation in terms of training and doing it in person. But this shows that evaluating the situation quickly and starting CPR will rarely do any harm."
Advice on when and how to give CPR is available from the American Heart Association.
SOURCES: Thomas D. Rea, M.D., associate professor, medicine, University of Washington, Seattle, and program medical director, King County Medic One, EMS Division, Kent, Wash.; Michael Sayre, M.D., professor, emergency medicine, Ohio State University, Columbus; Dec. 21, 2009, Circulation, online
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