Overview
OHCA, death, fatigue
ALTERNATION, WASTED
OHCA is a major cause of death worldwide, and high-quality CPR facilitates neurological outcomes and overall prognosis [The tele-instruction tool for multiple lay responders has good universality and promotional value. It was reported that 43.1% of OHCA resuscitation incidents involved multiple lay responders, more than half of which involved 3 or more lay responders [CPR has long been considered the hallmark of OHCA management, and chest compressions with an appropriate frequency and depth are a significant component of high-quality CPR. The team-based tele-instruction tool demonstrated a remarkable advantage in terms of chest compression quality. By counting loudly with a telecommunicator, the intervention group maintained a more suitable average compression rate. This was particularly obvious when the rescuers had just begun chest compressions or had just changed roles. Team-based instructions could help rescuers achieve a better effect quickly after beginning compression, shorten the time of adaptation, and facilitate efficient intrateam role alternation. In addition, the intervention group achieved a relatively greater compression depth (within 5-6 centimeters). It was assumed that team-based instructions could realize better team cooperation and more timely rotation, avoiding poor-quality resuscitation due to fatigue.Prompt emergency response is crucial for OHCA rescue [Feedback from the participants and experts provided support for the validity of the protocol and highlighted issues requiring improvement. First, many participants did not actively report to the telecommunicator during resuscitation, which may have wasted their valuable time. Second, telecommunicators should pay more attention to feedback from rescuers, adjust instructions in a timely manner, and offer psychological support and encouragement, which requires abundant work experience and an effective improvisation ability. However, it may be difficult for telecommunicators to achieve this on their own. Some studies used machine learning to assist telecommunicators in OHCA recognition and achieved better results [Nevertheless, this study had some limitations. First, a simulation trial was conducted with people who had mastered single-rescuer CPR skills to perform a targeted evaluation of the tool. However, in real-life OHCA situations, it is not certain whether lay responders equipped with resuscitation skills would be recruited. Therefore, we will further expand the compatibility by collecting more representative data to demonstrate the efficacy of the protocol. Second, due to some practical barriers, such as the disconnection of the call and the time-consuming task of information registration, our test may not have been completely simulated. Finally, although the study design could reduce the effect of confounding factors between the groups, the practice effect did exist and could have led to motivational bias.