Improving outcomes of out of hospital cardiac arrest (OHCA): applying behavioural science to enhance dispatcher assistance and increase rates of cardiopulmonary resuscitation

Out-of-hospital cardiac arrest is common and carries enormous mortality (higher in UK than other countries).

Immediate cardio-pulmonary resuscitation (CPR) reduces mortality but is often not provided, even when bystanders are trained and even when ambulance dispatchers provide instructions. Evidence now exists about techniques that enable people to change their behaviour (BCTs).

If BCTs were incorporated into the instructions given by dispatchers it might increase the proportion who perform CPR and save lives.

A programme of work to develop and test an intervention is proposed:1 – a theory-based analysis of calls to Emergency Dispatch Centres to identify the barriers encountered during CPR calls and techniques used by dispatchers to facilitate CPR.2 - a qualitative interview study to explore the experiences of dispatchers, synthesising their collective knowledge about what facilitates CPR.3 – use expert consensus to systematically and transparently select effective, feasible BCTs to deliver in the context of an emergency call and develop a behavioural science-informed dispatcher intervention (BIDI).

Test in a randomised, controlled, simulation trial whether BIDI increases rates of CPR initiation.

Applying the wealth of evidence accumulated for other behaviours (e.g. smoking) to behaviour of CPR offers a novel potential means to address this worldwide problem.