Instructions to "put the phone down" do not improve the quality of bystander initiated dispatcher-assisted cardiopulmonary resuscitation

Objective: The quality of early bystander CPR appears important in maximizing survival. This trial tests whether explicit instructions to "put the phone down" improve the quality of bystander initiated dispatch-assisted CPR. Methods: In a randomized, double-blinded, controlled trial, subjects were randomized to a modified version of the Medical Priority Dispatch System (R) (MPDS) version 11.2 protocol or a simplified protocol, each with or without instruction to "put the phone down" during CPR. Data were recorded from a Laerdal (R) Resusci (R) Anne Skillreporter (TM) manikin. A simulated emergency medical dispatcher, contacted by cell phone, delivered standardized instructions. Primary outcome measures included chest compression rate, depth, and the proportion of compressions without error, with correct hand position, adequate depth, and total release. Time was measured in two distinct ways: time required for initiation of CPR and total amount of time hands were off the chest during CPR. Proportions were analyzed by Witcoxon rank sum tests and time variables with ANOVA. AR tests used a two-sided alpha-level of 0.05. Results: Two hundred and fifteen subjects were randomized-107 in the "put the phone down" instruction group and 108 in the group without "put the phone down" instructions. The groups were comparable across demographic and experiential variables.