Modified cardiopulmonary resuscitation (CPR) instruction protocols for emergency medical dispatchers: Rationale and recommendations

Lynn P. Roppolo, Paul E. Pepe, Nicole Cimon, Marc Gay, Brett Patterson, Arthur Yancey, Jeff J. Clawson

Research output: Contribution to journalArticlepeer-review

45 Scopus citations


Background: International consensus guidelines now support the use of "chest compressions-only" cardiopulmonary resuscitation (CPR) instructions (CCOIs) by emergency medical dispatch (EMD) personnel providing telephone assistance to untrained bystanders at a cardiac arrest scene. These guidelines are based largely on evolving experimental data and a clinical trial conducted in one venue with distinct emergency medical services (EMS) system features. Accordingly, the Council of Standards for the National Academies of Emergency Dispatch was asked to adapt a modified telephone CPR protocol, and specifically one that could be applied more broadly to the spectrum of EMS systems. Methods: A group of international EMD specialists, researchers and professional association representatives analyzed available scientific data and considered variations in EMS systems, particularly those in Europe and North America. Results and conclusions: Several recommendations were established: (1) to avoid confusion, bystanders already providing CPR should continue those previously learned methods; (2) following a sudden collapse unlikely to be of respiratory etiology, CCOIs should be provided when the bystander is not CPR-trained, declining to perform mouth-to-mouth ventilation or unsure of actions to take; (3) following 4 min of CCOIs, ventilations can be provided, but, for now, only at a compression-ventilation ratio of 100:2 until EMS arrives; (4) until more data become available, dispatchers should follow existing compression-ventilation protocols for children and adult cases involving probable respiratory/trauma etiologies; (5) EMD CPR protocols should account for EMS system features and receive quality oversight and expert medical direction.

Original languageEnglish (US)
Pages (from-to)203-210
Number of pages8
Issue number2
StatePublished - May 2005


  • 9-1-1 Systems
  • Bystander CPR
  • Cardiac arrest
  • Cardiopulmonary resuscitation, CPR
  • Emergency medical dispatcher
  • Emergency medical services, EMS
  • Mouth-to-mouth resuscitation
  • Out-of hospital-CPR
  • Pre-arrival instruction
  • Sudden cardiac death
  • Ventilation

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine


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