Dispatch-Assisted CPR – Updated 2017

The 2017 BLS CoSTR summary1 and systematic review considered instructions for dispatch-assisted chest compression only CPR for out-of-hospital cardiac arrest (OHCA).

No new studies were reviewed for this topic in 2017.

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2015 Summary of Evidence

Evidence comparing layperson compression-only CPR with conventional CPR is derived from RCTs of dispatcher-guided CPR and observational studies. There were no short-term survival differences in any of the 3 individual randomized trials comparing the 2 types of dispatcher instructions.2,3,4 Based on meta-analysis of the 2 largest randomized trials (total n=2496), dispatcher instruction in compression-only CPR was associated with long-term survival benefit compared with instruction in chest compressions and rescue breathing.5 Among the observational studies, survival outcomes were not different when comparing the 2 types of CPR.6-13,14-18

Recommendations - Updated 2017

This recommendation is consistent with the 2010 and 2015 guidelines and has been updated for clarity.

We recommend that when dispatchers’ instructions are needed, dispatchers should provide chest compression–only CPR instructions to callers for adults with suspected OHCA. (Class I; LOE C-LD)



  1. Olasveengen TM, Caen AR, Mancini ME, Maconochie IK, Aickin R, Atkins DL, Berg RA, Bingham R, Brooks SC, Castrén M, Chung SP, Considine J, Couto TB, Escalante R, Gazmuri RJ, Guerguerian AM, T. H, Koster RW, Kudenchuk PJ, Lang E, Lim SH, Løfgren B, Meaney PA, Montgomery WH, Morley PT, Morrison LJ, Nation KJ, Ng KC, Nadkarni VM, Nishiyama C, Nuthall G, Ong YKG, Perkins GD, Reis AG, Ristagno G, Sakamoto T, Sayre MR, Schexnayder SM, Sierra A, Singletary EM, Shimizu N, Smyth MA, Stanton D, Tijssen JA, Travers AH, Vaillancourt C, van de Voorde P, Hazinski MF, Nolan JP; for the ILCOR Collaborators. 2017 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations summary. Circulation. 2017. In press.
  2. Svensson L, Bohm K, Castrèn M, Pettersson H, Engerström L, Herlitz J, Rosenqvist M. Compression-only CPR or standard CPR in out-of- hospital cardiac arrest. N Engl J Med. 2010;363:434–442. doi: 10.1056/ NEJMoa0908991.
  3. Rea TD, Fahrenbruch C, Culley L, Donohoe RT, Hambly C, Innes J, Bloomingdale M, Subido C, Romines S, Eisenberg MS. CPR with chest compression alone or with rescue breathing. N Engl J Med. 2010;363:423– 433. doi: 10.1056/NEJMoa0908993.
  4. HallstromA,CobbL,JohnsonE,CopassM.Cardiopulmonaryresuscitation by chest compression alone or with mouth-to-mouth ventilation. N Engl J Med. 2000;342:1546–1553. doi: 10.1056/NEJM200005253422101.
  5. Hüpfl M, Selig HF, Nagele P. Chest-compression-only versus standard cardiopulmonary resuscitation: a meta-analysis. Lancet. 2010;376:1552–1557. doi: 10.1016/S0140-6736(10)61454-7.
  6. Iwami T, Kawamura T, Hiraide A, Berg RA, Hayashi Y, Nishiuchi T, Kajino K, Yonemoto N, Yukioka H, Sugimoto H, Kakuchi H, Sase K, Yokoyama H, Nonogi H. Effectiveness of bystander-ini- tiated cardiac-only resuscitation for patients with out-of-hospital cardiac arrest. Circulation. 2007;116:2900–2907. doi: 10.1161/ CIRCULATIONAHA.107.723411.
  7. Kitamura T, Iwami T, Kawamura T, Nagao K, Tanaka H, Hiraide A; Implementation Working Group for All-Japan Utstein Registry of the Fire and Disaster Management Agency. Bystander-initiated rescue breath- ing for out-of-hospital cardiac arrests of noncardiac origin. Circulation. 2010;122:293–299. doi: 10.1161/CIRCULATIONAHA.109.926816.
  8. Kitamura T, Iwami T, Kawamura T, Nagao K, Tanaka H, Berg RA, Hiraide A; Implementation Working Group for All-Japan Utstein Registry of the Fire and Disaster Management Agency. Time-dependent effectiveness of chest compression-only and conventional cardiopulmonary resusci- tation for out-of-hospital cardiac arrest of cardiac origin. Resuscitation. 2011;82:3–9. doi: 10.1016/j.resuscitation.2010.09.468.
  9. Ong ME, Ng FS, Anushia P, Tham LP, Leong BS, Ong VY, Tiah L, Lim SH, Anantharaman V. Comparison of chest compression only and standard car- diopulmonary resuscitation for out-of-hospital cardiac arrest in Singapore. Resuscitation. 2008;78:119–126. doi: 10.1016/j.resuscitation.2008.03.012.
  10. SOS-KANTO Study Group. Cardiopulmonary resuscitation by bystand- ers with chest compression only (SOS-KANTO): an observational study. Lancet. 2007;369:920–926.
  11. Bobrow BJ, Spaite DW, Berg RA, Stolz U, Sanders AB, Kern KB, Vadeboncoeur TF, Clark LL, Gallagher JV, Stapczynski JS, LoVecchio F, Mullins TJ, Humble WO, Ewy GA. Chest compression-only CPR by lay rescuers and survival from out-of-hospital cardiac arrest. JAMA. 2010;304:1447–1454. doi: 10.1001/jama.2010.1392.
  12. Olasveengen TM, Wik L, Steen PA. Standard basic life support vs. continuous chest compressions only in out-of-hospital cardiac arrest. Acta Anaesthesiol Scand. 2008;52:914–919. doi: 10.1111/j.1399-6576.2008.01723.x.
  13. Panchal AR, Bobrow BJ, Spaite DW, Berg RA, Stolz U, Vadeboncoeur TF, Sanders AB, Kern KB, Ewy GA. Chest compression-only cardiopul- monary resuscitation performed by lay rescuers for adult out-of-hospital cardiac arrest due to non-cardiac aetiologies. Resuscitation. 2013;84:435– 439. doi: 10.1016/j.resuscitation.2012.07.038.
  14. Bohm K, Rosenqvist M, Herlitz J, Hollenberg J, Svensson L. Survival is similar after standard treatment and chest compres- sion only in out-of-hospital bystander cardiopulmonary resus- citation. Circulation. 2007;116:2908–2912. doi: 10.1161/ CIRCULATIONAHA.107.710194.
  15. Holmberg M, Holmberg S, Herlitz J; Swedish Cardiac Arrest Registry. Factors modifying the effect of bystander cardiopulmonary resuscitation on survival in out-of-hospital cardiac arrest patients in Sweden. Eur Heart J. 2001;22:511–519.
  16. Bossaert L, Van Hoeyweghen R. Evaluation of cardiopulmonary resus- citation (CPR) techniques. The Cerebral Resuscitation Study Group. Resuscitation. 1989;17 suppl:S99–S109; discussion S199.
  17. Gallagher EJ, Lombardi G, Gennis P. Effectiveness of bystander cardio- pulmonary resuscitation and survival following out-of-hospital cardiac arrest. JAMA. 1995;274:1922–1925.
  18. Mohler MJ, Wendel CS, Mosier J, Itty A, Fain M, Clark L, Bobrow B, Sanders AB. Cardiocerebral resuscitation improves out-of-hospi- tal survival in older adults. J Am Geriatr Soc. 2011;59:822–826. doi: 10.1111/j.1532-5415.2011.03400.x.
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Dispatch-Assisted CPR – Updated 2017