Effects of dispatcher-assisted bystander cardiopulmonary resuscitation on neurological recovery in paediatric patients with out-of-hospital cardiac arrest based on the pre-hospital emergency medical service response time interval

Objectives: We investigated the effect of bystander cardiopulmonary resuscitation (BCPR) with dispatcher assistance (DA) on neurological outcomes based on the response time interval (RTI) of the pre-hospital emergency medical service (EMS) among paediatric patients with out-of-hospital cardiac arrest (OHCA). Methods: This retrospective registry study was conducted on paediatric patients (< 19 years old) with OHCA who were assessed by EMS providers between 2012 and 2016. The primary outcome was good neurological recovery based on BCPR with or without DA and the EMS RTI. Differential effects of BCPR with DA based on the EMS RTI were analysed by multivariable logistic regression analysis with interaction terms. Results: Adjusted odds ratios (AORs) and corresponding 95% confidence intervals (95% CIs) for good neurological recovery were 2.22 (1.27-3.88) for BCPR with DA and 1.51 (0.77-2.97) for BCPR without DA compared to no BCPR. The faster EMS RTI group (< 5 min) had better neurological recovery than the later EMS RTI group (>= 5 min) (AOR: 1.87 [1.04-3.29]). The AORs for good neurological recovery following BCPR with DA based on the EMS RTI were 2.52 (0.91-6.97) in the faster EMS RTI group and 2.17 (1.13-4.19) in the later EMS RTI group compared to the no BCPR group. Conclusion: BCPR with DA and a faster EMS RTI were significantly associated with good neurological recovery in paediatric patients with OHCA. When the EMS RTI was delayed, the association of BCPR with DA with good neurological recovery was preserved in paediatric patients with OHCA.