Out-of-hospital cardiac arrest (OHCA) remains a leading cause of mortality worldwide, with survival highly dependent on the immediate initiation of bystander cardiopulmonary resuscitation (CPR). Early recognition, prompt chest compressions, and rapid defibrillation are critical components of the chain of survival. Telephone-assisted CPR (T-CPR) provided by emergency dispatchers has been shown to significantly increase bystander intervention rates and improve outcomes. While the availability and use of automated external defibrillators (AEDs) further enhance survival, the optimal integration of AED use into dispatcher-guided, single-rescuer scenarios remains insufficiently studied.
This prospective, randomized, controlled simulation study aims to evaluate the effect of modified telephone cardiopulmonary resuscitation (T-CPR) instructions optimized for automated external defibrillator (AED) use on no-flow time and chest compression fraction (CCF) during single-rescuer resuscitation. Participants are randomized to receive either standard T-CPR instructions or enhanced instructions focusing on minimizing interruptions in chest compressions and reducing time to first compression during AED use.
Adolescents and adults (≥16 years)
Healthcare professionals or laypersons
Voluntary participation
pregnant women
people with cardio-pulmonary and musculoskeletal diseases or any other impairment that would risk harm for the volunteer while performing CPR
physical and/or psychological disabilities
technical issue during data collection
Parallel
T-CPR
BehavioralParticipants receive structured telephone CPR instructions reflecting current national practice. AED retrieval is instructed early; however, no additional guidance is provided to optimize timing or minimize interruptions during AED use.
AED-optimized T-CPR
BehavioralParticipants receive standard T-CPR instructions supplemented with specific guidance aimed at: * minimizing interruptions in chest compressions, * reducing time to first chest compression, * optimizing AED use workflow. Key elements include: * immediate activation of the AED upon retrieval, * initiation of chest compressions even if AED voice prompts have not yet reached relevant steps, * continuation of compressions during AED preparation and charging (when appropriate), * minimization of pauses before and after shock delivery.
No-flow time
Time without chest compressions measured from entry into the simulation (collapse recognition) until termination of the scenario (giving the third shock).
Time to first chest compression
The time (in seconds) until the first chest compression (measured from entering the scenario).
Time to first shock
The time to the first shock by the AED (in seconds, from the time of entering the scenario).
Chest compression fraction
Proportion of time during which chest compressions are performed (until giving the third shock), calculated from the first chest compression until scenario termination.
Peri-shock pause
The time without chest compression (in seconds) before and after giving the shock.
Attitude about T-CPR instructions
Subjective feelings after performing cardiopulmonary resuscitation based on a short survey using Likert-scale based queries (1-4 points, lower numbers indicate worse, higher score indicates better opinion).
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