Adapting Telecommunicator CPR Instructions to Enhance Layperson Response to Pediatric Cardiac Arrest

About This Grant

PROJECT SUMMARY Survival of pediatric (age <18 years) out-of-hospital cardiac arrest (OHCA) depends on bystander cardiopulmonary resuscitation (CPR) administered by layperson community members until the arrival of emergency medical services (EMS) personnel. Unfortunately, CPR participation rates vary widely across the U.S. and are particularly low in Alabama, contributing to one of the nation’s lowest OHCA survival rates. Telecommunicator CPR (T-CPR) protocols, in which 9-1-1 call takers partner with the caller to identify an individual experiencing OHCA and provide real-time CPR instructions, may help improve recognition of pediatric OHCA and CPR delivery. However, no protocol has been developed and tested in populations of the Deep South. Our central hypothesis is that a tailored version of the commonly used ‘No, No, Go!’ T-CPR protocol for pediatric OHCA, co-adapted by community members and EMS stakeholders in Birmingham, Alabama, will result in high-quality CPR delivery and high participant satisfaction. We will test our hypothesis through the following specific aims: In Aim 1, we will evaluate the 'No, No, Go!' T-CPR protocol for pediatric OHCA through high-fidelity simulated OHCA sessions conducted with Birmingham community members residing in high-risk OHCA neighborhoods. We will assess implementation outcomes including feasibility, fidelity, acceptability, and appropriateness. Following the simulations, focus groups with participants will be conducted to gather feedback on the protocol and generate recommendations for improvement. In Aim 2, we will co-adapt the pediatric 'No, No, Go!' T-CPR protocol evaluated in Aim 1 in collaboration with community members and EMS stakeholders. We will then pilot a novel prototype T-CPR protocol designed to improve the effectiveness of bystander CPR delivery for pediatric OHCA by lay rescuers. This work builds upon Dr. Coute’s prior findings from his NHLBI K23 award and American Heart Association Early Independence Award focused on adult OHCA and will provide critical preliminary data to support a future R-level implementation trial.