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Although early bystander-initiated cardiopulmonary resuscitation (CPR) is a key factor in survival improvement from out-of-hospital cardiac arrest, only one-third of victims actually receive CPR before arrival of emergency medical services. Dispatcher-assisted telephone CPR might improve the frequency and performance of bystanders' resuscitation efforts. Due to the recent interest in hands-only CPR protocol  and the lack of any French validated algorithm, we designed the present study in order to validate a new French protocol called ALERT (Algorithme Liègeois d'Encadrement à la Réanimation par Téléphone).
We tested the efficacy of the ALERT protocol on CPR performances in a manikin model of cardiac arrest. Participants (n = 110) were divided into four groups. Previously untrained subjects, distributed into two sub-groups depending on whether they were beneficiating from telephone assistance (PUG group, n = 30) or not (PUNG group, n = 30), were compared with previously trained nurses students distributed in two other sub-groups: with (PTG group, n = 25) or without (PTNG group, n = 25) telephone assistance.
Global evaluation of CPR performances in untrained volunteers benefiting from telephone assistance revealed a significant improvement as compared with unguided untrained volunteers. Indeed, they approached CPR performance levels of previously trained nurse students with no dispatcher's guidance. Previously trained nurses with telephone assistance gained the best CPR scores, notably because of an improvement in the quality of airway management.
Our results indicate that use of the ALERT algorithm by dispatchers may improve the CPR performance in both previously untrained volunteers and in volunteers with prior basic life support training.