Resuscitation plus最新文献

{"title":"The extracorporeal cardiopulmonary resuscitation outcomes database","authors":"Chloe R Skidmore,&nbsp;Christopher M. Evola,&nbsp;Anna L. Ciullo,&nbsp;Heidi Alvey,&nbsp;Brian Grunau,&nbsp;Kyle Gunnerson,&nbsp;Peter England,&nbsp;Nicholas J. Johnson,&nbsp;Joseph E. Tonna","doi":"10.1016/j.resplu.2026.101392","DOIUrl":"10.1016/j.resplu.2026.101392","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac arrest impacts more than 500,000 people in the United States annually. Overall, cardiac arrest, particularly when it occurs outside of a hospital, is associated with low rates of survival and poor neurologic recovery. Extracorporeal cardiopulmonary resuscitation (ECPR), or the use of extracorporeal membrane oxygenation (ECMO) during the cardiopulmonary resuscitation (CPR) process, has increased in recent years. The Extracorporeal Resuscitation Outcomes Database (EROD) aims to serve as a source of highly detailed, granular data for research on ECPR. This paper represents the inaugural report from EROD.</div></div><div><h3>Methods</h3><div>We created EROD, which collects prospective data on adult cardiac arrest cases treated with ECPR, including demographics, medical history, cardiac arrest characteristics, the ECMO cannulation process, post-cannulation care, hospital treatments and diagnostics, neuroprognostication, complications, and outcomes.</div></div><div><h3>Results</h3><div>Five centers in North America contributed data (<em>n</em> = 113) to EROD between March 2017 and March 2022. The majority White (64%) and male (78%) sample had a significant medical history prior to their cardiac arrest (73%). Most patients arrested pre-hospital (65%) and received bystander CPR (81%). ECMO cannulation most often took place in an emergency department (67%) and was done by a Cardiothoracic Surgery provider (76%). Common complications included acute kidney injury (49%), major bleeding (29%), vascular injury (19%), and limb ischemia (14%), among others. One quarter of patients survived to hospital discharge (25%) and had an average hospital length of stay of 22 days (SD 15.5). Of the whole sample, there was an average time of 84 min from time of cardiac arrest to ECMO cannulation (SD 54) and patients spent an average of 107 h and 56 min on ECMO (SD 73:53). Of the 25% who survived (<em>n</em> = 28), the majority had positive neurologic outcomes with a Cerebral Performance Category (CPC) score of 1 (<em>n</em> = 15), indicating no or mild cerebral disability, or a CPC of 2 (<em>n</em> = 5), indicating moderate cerebral disability.</div></div><div><h3>Conclusion</h3><div>This paper introduces EROD and presents data from the initial 113 patients entered into the registry from 2017 to 2022. Initial analysis demonstrated survival rates that align with national averages, even with longer durations of CPR prior to ECMO cannulation. Utilization of this registry, as well as others, is crucial in identifying and establishing standardized ECPR practices that deliver the best possible outcomes for patients.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101392"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13355784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148427672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reasons why smartphone-alerted first responders abort missions","authors":"Stephanie Stein,&nbsp;Carolin Braun,&nbsp;Bernd Reuschenbach,&nbsp;Stephan Prückner,&nbsp;Nadine Liebchen","doi":"10.1016/j.resplu.2026.101404","DOIUrl":"10.1016/j.resplu.2026.101404","url":null,"abstract":"<div><h3>Background</h3><div>Smartphone-based first responder systems are implemented in 209 regions across Germany to reduce time to treatment in out-of-hospital cardiac arrests (OHCA). However, more than 20% of alerted responders abort a mission after accepting the alert. Understanding the underlying reasons is important for improving the prehospital chain of survival.</div></div><div><h3>Methods</h3><div>We conducted a mixed-methods study comprising of (1) semi-structured interviews with smartphone-alerted first responders in Munich to identify and categorise reasons why missions are aborted, and (2) a subsequent quantitative online survey sent to all registered users of the <em>Mobile Retter</em> smartphone app in Munich to determine the frequency of these categories.</div></div><div><h3>Results</h3><div>Four semi-structured telephone interviews identified six categories with two to three subcodes through qualitative content analysis, which informed questionnaire development. Based on this questionnaire, 334 responder feedbacks were analysed. Among responders, 130 (38.9%) reported aborting a mission after acceptance; 204 had never discontinued a mission. Lack of time advantage over dispatched emergency medical services was the most frequently reported reason for aborting missions (<em>n</em> = 89; 41.8%). An additional 21.6% reported excessive estimated distance, and 12.2% could not locate the emergency site. Further reasons included presumed medically unnecessary alarms and situational unavailability.</div></div><div><h3>Conclusion</h3><div>Smartphone-alerted first responders were more likely to abort missions due to structural and informational factors rather than safety concerns. Optimising dispatch information, tracking and alert processes, improving emergency site localisation, and refining spatial alerting criteria may reduce discontinued missions and strengthen system effectiveness in urban areas.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101404"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148567266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translation and psychometric validation of the Intent-to-Aid survey for bystander response among French-speaking CPR-trained populations","authors":"Marco Pedrotti,&nbsp;Baptiste Lucien,&nbsp;Philippe Terrier,&nbsp;Jérémy Torrent,&nbsp;Sandrine Dénéréaz,&nbsp;Thierry Spichiger,&nbsp;Christophe Bélet,&nbsp;Jeffrey L. Pellegrino","doi":"10.1016/j.resplu.2026.101400","DOIUrl":"10.1016/j.resplu.2026.101400","url":null,"abstract":"<div><h3>Background</h3><div>Bystander cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use are critical determinants of survival after out-of-hospital cardiac arrest (OHCA). These behaviors are influenced not only by knowledge and skills but also by affective determinants such as confidence, attitudes, and social norms. The Intent-to-Aid (I2A) survey was developed to measure these constructs. The European Resuscitation Council (ERC) has highlighted the need for tools to evaluate resuscitation education outcomes in non-English-speaking populations to support equitable access to training.</div></div><div><h3>Objective</h3><div>To translate, culturally adapt, and psychometrically validate the I2A for French-speaking CPR-trained individuals.</div></div><div><h3>Methods</h3><div>The I2A was translated using forward–backward procedures, expert review, and cognitive debriefing. In a cross-sectional study of French-speaking CPR-trained adults in Switzerland (<em>N</em> = 378), confirmatory factor analyses (CFA) were conducted at parcel and item levels. Internal consistency was assessed using Cronbach’s alpha and McDonald’s omega, and associations between Theory of Planned Behavior constructs were examined to assess theoretical coherence.</div></div><div><h3>Results</h3><div>The original four-factor structure (Attitudes, Norms, Confidence, Intentions) was replicated in parcel-based CFA, demonstrating excellent overall model fit. Item-level CFA supported the same structure after removing one item with extreme ceiling effects. Internal consistency ranged from acceptable to excellent (<em>α</em> = 0.66–0.87; <em>ω</em> = 0.75–0.90). Confidence and Norms explained most variance in Intentions, highlighting potential targets for resuscitation education.</div></div><div><h3>Conclusions</h3><div>The I2A-French demonstrates robust structural validity, satisfactory reliability, and theoretical coherence in highly trained CPR populations, supporting its use for evaluating affective determinants of bystander CPR response.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101400"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148567317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of pediatric drowning out-of-hospital cardiac arrests in the United States","authors":"Christopher E. Gaw,&nbsp;Chelsea B. Kadish,&nbsp;Christopher B. Gage,&nbsp;Sara Helwig,&nbsp;Jacob C. Kamholz,&nbsp;Shea L. van den Bergh,&nbsp;Kayla M. Riel,&nbsp;Ashish R. Panchal","doi":"10.1016/j.resplu.2026.101413","DOIUrl":"10.1016/j.resplu.2026.101413","url":null,"abstract":"<div><h3>Aims</h3><div>Drowning is a leading cause of pediatric death in the United States, yet data characterizing these arrests is limited. Our study aimed to describe demographic and emergency medical services (EMS) response characteristics for drowning-related pediatric out-of-hospital cardiac arrests (pOHCAs).</div></div><div><h3>Methods</h3><div>Using the 2023 National Emergency Medical Services Information System dataset, we conducted a cross-sectional study of EMS-attended 9-1-1 responses involving children 1 day–17 years old who experienced a drowning-related pOHCA. We used descriptive statistics and multivariable logistic regression (adjusted odds ratio; 95% confidence intervals) to identify factors associated with return of spontaneous circulation (ROSC).</div></div><div><h3>Results</h3><div>Our study included 753 drowning-related pOHCAs. Most arrests were toddlers aged 1–4 years (57.8%), males (64.5%), at private residences (72.5%), and in urban settings (83.7%). EMS clinicians were commonly dispatched during the summer (46.7%) and between 12:00 and 17:59 (47.4%). Arrests were often unwitnessed (73.7%) and received bystander cardiopulmonary resuscitation (CPR) (81.3%). Fifty-four percent of adolescent arrests were unwitnessed compared to 80.5% among toddlers (<em>P</em> &lt; 0.001). Most arrests (81.3%) received bystander CPR. Shockable rhythms were uncommon (4.6%). EMS-witnessed ROSC was obtained in 42.0% of arrests. In multivariable regression, adolescent age (3.25; 1.25–8.79), witnessed arrests (1.59; 1.03–2.45), and bystander CPR (2.83; 1.67–4.96) were associated with higher odds of ROSC.</div></div><div><h3>Conclusions</h3><div>Most drowning-related pOHCAs involved young children, with age-based differences in scene characteristics and pre-EMS arrival factors. Adolescent arrests were more frequently witnessed and more likely to obtain ROSC. Opportunities exist to improve drowning prevention among children and enhance the chain of survival.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101413"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148634653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of locally processed neuron-specific enolase is associated with improved guideline-concordant neuroprognostication after out-of-hospital cardiac arrest: a retrospective before-and-after study","authors":"Christopher D. Smith,&nbsp;Saxon Douglass,&nbsp;Nilesh A. Devanand,&nbsp;Daniel C. Adair,&nbsp;Samantha Nankivell,&nbsp;Megan Freeman,&nbsp;Philip Emerson,&nbsp;Peter Hibbert,&nbsp;Luke Collett,&nbsp;Krishnaswamy Sundararajan","doi":"10.1016/j.resplu.2026.101418","DOIUrl":"10.1016/j.resplu.2026.101418","url":null,"abstract":"<div><h3>Background</h3><div>For comatose survivors of out-of-hospital cardiac arrest (OHCA), accurate neuroprognostication enables shared decision-making and avoids premature or unnecessarily delayed withdrawal of life-sustaining treatment. Guidelines recommend a multimodal approach requiring at least two independent poor-prognostic criteria, of which neuron-specific enolase (NSE) is currently the primary endorsed serum biomarker. NSE is not consistently used, and guideline adherence remains variable internationally.</div></div><div><h3>Objectives</h3><div>To evaluate whether locally processed NSE improved guideline-concordant neuroprognostication and decision-making timelines after OHCA.</div></div><div><h3>Methods</h3><div>A single-centre retrospective before-and-after study at an Australian quaternary intensive care unit (ICU) compared control (January 2022–July 2024) and intervention (August 2024–March 2026) periods. Sixty-nine comatose adults who underwent withdrawal of life-sustaining treatment on neurological grounds after OHCA were included. The primary outcome was guideline-concordant neuroprognostication (≥2 multimodal poor-prognostic criteria). Secondary outcomes were time to clinical determination of a poor neurological prognosis and prognostic disclosure to the family.</div></div><div><h3>Results</h3><div>Guideline-concordant neuroprognostication increased from 35.9% (14/39) to 63.3% (19/30), an absolute increase of 27.4% (<em>p</em> = 0.030). Cumulative sum analysis showed sustained improvement throughout the intervention period. Time to clinical determination of a poor neurological prognosis (87.0 vs 88.4 h, <em>p</em> = 0.66) and prognostic disclosure to the family (91.6 vs 92.4 h, <em>p</em> = 0.69) were unchanged.</div></div><div><h3>Conclusions</h3><div>Implementation of locally processed NSE was associated with a statistically significant increase in guideline-concordant multimodal neuroprognostication. Decision-making timelines were unchanged, consistent with prognostication being shaped by human and system-level factors beyond diagnostic availability. NSE availability was not associated with earlier withdrawal of life-sustaining treatment.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101418"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148634664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond feasibility: does simulation-based POCUS training translate into clinically meaningful pediatric arrest performance?","authors":"Thirunavukkarasu Arun Babu,&nbsp;Vijayan Sharmila","doi":"10.1016/j.resplu.2026.101402","DOIUrl":"10.1016/j.resplu.2026.101402","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101402"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148737189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of in-hospital cardiac arrest aetiologies and return of spontaneous circulation","authors":"Peter Carøe Lind,&nbsp;Lars Wiuff Andersen,&nbsp;Asger Granfeldt","doi":"10.1016/j.resplu.2026.101397","DOIUrl":"10.1016/j.resplu.2026.101397","url":null,"abstract":"<div><h3>Background</h3><div>Guidelines emphasise that reversible causes of cardiac arrest are identified to improve the chance of successful resuscitation and return of spontaneous circulation (ROSC). In this study, we investigated the effect of correct identification of in-hospital cardiac arrest (IHCA) aetiologies on the rate of ROSC in patients without obvious aetiology.</div></div><div><h3>Methods</h3><div>This study was a post-hoc analysis of the WHY-IHCA study and leveraged data on presumed IHCA aetiologies and on expert panel-assessed IHCA aetiologies from this study. Correct identification of aetiology was defined as patients where the presumed aetiology was the same as the aetiology assessed by at least 3 of 4 experts. The effect of correct identification of IHCA aetiologies on the rate of ROSC was assessed using logistic regression with adjustment for age, witnessed status, monitored status, shockable status, and actual aetiology.</div></div><div><h3>Results</h3><div>A total of 150 patients were included of which the aetiology was correctly identified in 80 (53%) patients. The rate of ROSC was 54% and 41% in those with and without correct identification of aetiology, respectively. After adjustment for confounders, correct aetiology identification resulted in a 1.88 (95% confidence interval: 0.77–4.57) times higher odds of ROSC. Results were similar in exploratory analyses of more stringent and more liberal definitions of correct aetiology identification.</div></div><div><h3>Conclusion</h3><div>The rate of ROSC is higher in patients in whom the aetiology of IHCA is correctly recognised. After adjustment for confounders, correct identification of aetiologies resulted in a numerically higher, although not statistically significant, odds of ROSC.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101397"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148554572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Web-based versus simulation-based refresher training in newborn life support","authors":"Kathleen Parthey,&nbsp;Anne Goldhahn,&nbsp;Anselm Linke,&nbsp;Katja Raberger,&nbsp;A. Wienke,&nbsp;Dietrich Stoevesandt,&nbsp;Roland Haase,&nbsp;for the NeoLITE-Study","doi":"10.1016/j.resplu.2026.101382","DOIUrl":"10.1016/j.resplu.2026.101382","url":null,"abstract":"<div><h3>Background</h3><div>Regular training for healthcare professionals in newborn life support is life-saving. Web-based refresher has the potential to be non-inferior to simulation-based refresher training.</div></div><div><h3>Methods</h3><div>The multicenter non-inferiority randomized controlled trial was conducted in six hospitals Level I–IV in Germany. Following an initial full-scale, high-fidelity simulation training, we compared a web-based refresher with a simulation-based refresher. The professionals were assessed at three points in time, using a pseudonymised questionnaire and a Megacode test, scores added up to a sum score. Assessment was performed prior to, and immediately after the initial training and three months after the intervention. The primary aim was to analyze whether a web-based refresher is non-inferior in avoiding skill decay. Participation at the refresher and recurring errors were secondary outcomes.</div></div><div><h3>Results</h3><div>Of 228 randomized healthcare professionals, 139 (web-based refresher group <em>n</em> = 78 vs. simulation-based refresher group <em>n</em> = 61) completed the study per protocol. The mean sum scores ± SD 3 months after the refresher was 47.0 ± 5.6 in the simulation-based group and 45.2 ± 6.5 in the web-based group (mean difference −1.7 ± 1.05 standard error), with similar results in the sensitivity test per modified intention-to-treat (Fig. 2). The lower limit of the one-sided 95% confidence interval (CI) did not exceed the predefined non-inferiority limit of <em>δ</em> = 5 points in both analyses (per protocol: one-sided 95% CI = −3.45; modified intention to treat: one-sided 95% CI = −1.95; Fig. 3). The participation in the web-based group was 14% higher. Incorrect adrenaline application and incorrect ventilation fraction, for example, were identified as recurring errors.</div></div><div><h3>Conclusion</h3><div>Although underpowered to make a firm inference, our results suggest that web-based refresher is non-inferior compared to simulation-based refresher training, even in practical skills and shows a higher participation rate.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101382"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on the journal article entitled “Translation and pilot testing of the ReSPECT form into Danish” published in Resuscitation Plus May 2026","authors":"Charlotte Hardy","doi":"10.1016/j.resplu.2026.101387","DOIUrl":"10.1016/j.resplu.2026.101387","url":null,"abstract":"","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101387"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dispatcher-assisted AED use in single-rescuer cardiac arrest: study protocol for a randomized simulation study comparing standard and optimized dispatcher-assisted CPR instructions","authors":"Barnabás Balassa,&nbsp;Henrietta Bánfai-Csonka,&nbsp;József Betlehem,&nbsp;Bernd W. Böttiger,&nbsp;Bálint Bánfai","doi":"10.1016/j.resplu.2026.101412","DOIUrl":"10.1016/j.resplu.2026.101412","url":null,"abstract":"<div><h3>Background</h3><div>Although automated external defibrillators (AEDs) improve outcomes in shockable rhythms, their use introduces interruptions in chest compressions. In single-rescuer scenarios, AED retrieval and application may further increase no-flow time. The effect of dispatcher instruction strategy on these interruptions remains unclear. This study aims to evaluate whether AED-optimized dispatcher-assisted CPR (DACPR) instructions reduce no-flow time compared with standard instructions in a simulated single-rescuer OHCA setting.</div></div><div><h3>Methods</h3><div>This prospective, randomized, controlled, parallel-group simulation trial will include adult laypersons and healthcare professionals. Participants will be allocated in a 1:1 ratio to either standard or AED-optimized DACPR instruction groups. All scenarios will be conducted in a controlled simulation environment with standardized AED accessibility (≤1 min retrieval distance) to isolate the effect of dispatcher communication on CPR performance. The primary outcome will be total no-flow time. Secondary outcomes include chest compression fraction, time to first compression, time to first shock, peri-shock pauses, and CPR quality metrics.</div></div><div><h3>Discussion</h3><div>This study investigates dispatcher instruction as a modifiable determinant of CPR interruption during AED use in single-rescuer scenarios. Findings will provide mechanistic insight into how communication strategies influence CPR quality under controlled conditions and may inform refinement of DACPR protocols.</div></div><div><h3>Ethics and dissemination</h3><div>The study protocol was approved by the Institutional Ethics Committee of the University of Pécs (PTE/87175-1/2025). Written informed consent will be obtained. Results will be disseminated via peer-reviewed publication and scientific conferences.</div></div><div><h3>Trial registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>: NCT07520877, prospectively registered on 8 April 2026.</div></div>","PeriodicalId":94192,"journal":{"name":"Resuscitation plus","volume":"30 ","pages":"Article 101412"},"PeriodicalIF":3.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148634526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}