Successful Linkage of 'Chain of Survival' in Out-of-Hospital Cardiac Arrest: Two Cases of dispatcher-assisted Cardiopulmonary Resuscitation in Korea

ABSTRACT

The use of concept of 'chain of survival' in American Heart Association has been published (proposed) for improving outcome in out-of-hospital cardiac arrest (OHCA) patients. We reported on two resuscitated OHCA cases whose 'chain of survival' were successfully linked. In particular, we presented process and time intervals of dispatcher-assisted cardiopulmonary resuscitation (CPR) instruction which have never been reported in Korea. These witnessed OHCA patients received bystander CPR instructed by dispatchers working in the 119 dispatch center. Automated external defibrillation was immediately attached and shocks were delivered effectively several times by 119 rescuers in the field. These patients were rapidly transported to regional emergency centers. Return of spontaneous circulation was achieved prior to arrival at hospital. Post-resuscitation care included therapeutic hypothermia or primary coronary intervention was performed after admission. These patients were discharged alive with good neurologic outcome. Comprehensive efforts of community, pre-hospital healthcare providers including dispatchers and hospitals are needed for successful linkage of 'chain of survival' in OHCA.