Experiences, challenges, and best practices of dispatcher-assisted cardiopulmonary resuscitation: a scoping review

Background Out-of-hospital cardiac arrest is a leading cause of mortality, with survival rates from 8 to 13%. Dispatcherassisted cardiopulmonary resuscitation (DA-CPR) may increase bystander-initiated CPR, improving survival outcomes. Despite these benefits, DA-CPR is often hindered by barriers and organizational issues. Objective To map and summarize the existing literature on DA-CPR, to identify strategies to improve provision rates, overcoming potential barriers. Eligibility criteria Primary studies with an English abstract, published between 2018 and 2024, focusing on experiences, challenges, and best practices related to DA-CPR. Studies were included if they reported on emergency callers and dispatchers (population), focusing on DA-CPR provision methods (concept), in any setting (context). Simulation studies were excluded. Sources of evidence The following databases were searched: Medline (PubMed), EMBASE, CINAHL, and the Cochrane Library. Grey literature from repositories, conference proceedings, and social media were also reviewed. Charting methods Characteristics of the included studies were reported in a specific extraction table and synthesized narratively. Results Fifty-eight studies were included. Results were categorized into themes (dispatcher, caller, system, and community/ context). Dispatcher training, simplified protocols, effective communication, and video calls emerged as elements potentially improving DA-CPR provision. Caller-related barriers like emotional distress and language problems were prevalent. Systemlevel interventions, including centralized call-handling and performance evaluations, improved DA-CPR rates. Community initiatives for CPR education enhanced bystander compliance. Conclusions This scoping review identifies strategies to enhance DA-CPR provision, emphasizing tailored dispatcher protocols, communication strategies, system-level improvements, and community-based interventions. Future research should evaluate the effectiveness of these strategies to optimize out-of-hospital cardiac arrest response.