Emergency Medicine

Milwaukee County Dispatcher Assisted Bystander CPR

The Milwaukee County Dispatcher Assisted Bystander CPR program is dedicated to increasing the overall cardiac arrest survival rate within the County. Through funding provided by Advancing Healthier Wisconsin Endowment Healthier Wisconsin Partnership Program (HWPP), the Dispatcher CPR program will create system change with the goal of improving cardiac arrest survival rates in Milwaukee County. This improvement will take place by making dispatcher assisted bystander CPR pre-arrival instructions available to all callers in the County.

Out-of-hospital cardiac arrest is a significant health problem in Milwaukee County. Only 10% of out-of-hospital cardiac arrest patients treated in the County survive to hospital discharge. When CPR is started by bystanders, the odds of survival double, however, bystander CPR is attempted on only 19% of cardiac arrest victims in this County. This rate could be improved if every 911 caller received CPR coaching. With the implementation of dispatcher assisted CPR instructions in Seattle, Washington, the rate of bystander CPR doubled and survival rates for the entire County increased.

See how dispatcher CPR will be provided for each municipality (PDF)

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Academic Resources

American Heart Association Guidelines for CPR
American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Dispatcher Specific
Impact of Telephone Dispatcher Assistance on the Outcomes of Pediatric Out-of-Hospital Cardiac Arrest

Evaluation of Dispatcher-Assisted Cardiopulmonary Resuscitation

Dispatcher-Assisted Telephone CPR: Common Delays and Time Standards for Delivery

Emergency CPR Instruction via Telephone

Sensitivity and Specificity of the Medical Priority Dispatch System in Detecting Cardiac Arrest Emergency Calls in Melbourne

Emergency Call Processing and Survival from Out-of-Hospital Ventricular Fibrillation

Evaluation of Emergency Medical Dispatch in Out-of-Hospital Cardiac Arrest in Taipei

Dispatcher-Assisted Cardiopulmonary Resuscitation and Survival in Cardiac Arrest

Implementation of the ALERT Algorithm, A New Dispatcher-Assisted Telephone Cardiopulmonary Resuscitation Protocol, in Non-Advanced Medical Priority Dispatch System (AMPDS) Emergency Medical Services Centres

The Continuous Quality Improvement Project for Telephone-Assisted Instruction of Cardiopulmonary Resuscitation Increased the Incidence of Bystander CPR and Improved the Outcomes of Out-of-Hospital Cardiac Arrests

Cardiac Arrest Diagnostic Accuracy of 9-1-1 Dispatchers: A Prospective Multi-Center Study

Evaluating the Effectiveness of Dispatch-Assisted Cardiopulmonary Resuscitation Instructions

Importance of Bystander CPR implementation
Emergency Medical Service Dispatch Cardiopulmonary Resuscitation Pre-arrival Instructions to Improve Survival from Out-of-Hospital Cardiac Arrest: A Scientific Statement from the American Heart Association

Bystander CPR improving Survival during Out of Hospital Cardiac Arrest
Comparison of Chest Compression Only and Standard Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrest in Singapore

Temporal trends in sudden cardiac arrest: a 25-year emergency medical services perspective

Predictors of Survival from Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-analysis

Benefits of Compression only CPR
Chest Compression-Only CPR by Lay Rescuers and Survival from Out-of-Hospital Cardiac Arrest

Survival is Similar After Standard Treatment and Chest Compression Only in Out-of-Hospital Bystander Cardiopulmonary Resuscitation

Changing EMS Dispatcher CPR Instructions to 400 Compressions before Mouth-to-Mouth Improved Bystander CPR Rates

Simplified Dispatch-Assisted CPR Instructions Outperform Standard Protocol

Cardiopulmonary Resuscitation by Chest Compression Alone or with Mouth to Mouth Ventilation

Chest Compression-Only CPR: A Meta-Analysis

Cardiocerebral Resuscitation Improves Out-of-Hospital Survival in Older Adults

Compression-Only Cardiopulmonary Resuscitation: An Updated Meta-analysis of Observational Studies

Conventional CPR vs. Compression Only CPR
Chest Compression-Only Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrest with Public-Access Defibrillation

Effectiveness of Bystander-Initiated Cardiac-Only Resuscitation for Patients with Out-of-Hospital Cardiac Arrest

Bystander-initiated Rescue Breathing for Out-of-Hospital Cardiac Arrests of Noncardiac Origin

Cardiopulmonary Resuscitation by Bystanders with Chest Compression Only (SOS-KANTO): An Observational Study

Chest Compression-Only Cardiopulmonary Resuscitation performed by Lay Rescuers for Adult Out-of-Hospital Cardiac Arrest due to Non-Cardiac Aetiologies

CPR with Chest Compression Alone or with Rescue Breathing

Compression-Only CPR or Standard CPR in Out-of-Hospital Cardiac Arrest

Factors which Influence the Effect of Bystander CPR
Bystander Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest

Effectiveness of Bystander Cardiopulmonary Resuscitation and Survival Following Out-of-Hospital Cardiac Arrest

Factors Modifying the Effect of Bystander Cardiopulmonary Resuscitation on Survival in Out-of-Hospital Cardiac Arrest Patients in Sweden

Dispatcher Toolkit

Cardiac arrest is a public health problem across the state of Wisconsin as well as across the country. In Wisconsin, there are approximately 6,500 cardiac arrests treated by EMS annually, of which only 19% are documented as receiving treatments (i.e., bystander CPR) prior to EMS arrival. This is dramatically lower than the 32% rate of bystander CPR seen nationally. Therefore, we are providing the items below as a tool kit for implementing dispatcher assisted bystander CPR in your community since it has been shown that this can double the rate of bystander CPR in a community. Please contact us if you have questions or would like assistance with starting your own program. (milwaukeecountybystandercpr@gmail.com)

Dispatcher CPR Protocols
PSAP protocol for identifying cardiac arrest (PDF)
Dispatcher protocol for providing CPR Instructions (DOCX)
Protocol for identifying cardiac arrest and providing CPR instructions (PDF)

Educational Materials
PSAP Training Slides (PPTX)
PSAP Review Slides (PPTX)

Dispatcher Training Slides
Part 1: Project Vision (PPTX)
Part 2: Identifying Patients (PPTX)
Part 3: Moving Callers from Reporters to Actors (PPTX)
Part 4: The Instructions (PPTX)
Dispatcher Practice Scenarios (PDF)

Data Forms for Quality Assurance
Dispatcher Data Form (PDF)
QI Data Form (PDF)