These CPR pre-arrival CPR audio files are provided as examples and can be used for educational purposes and training.  Dispatch centers should review and maintain their own audio files for QI and training purposes.

Audio file #1 is an example of suboptimal CPR pre-arrival instructions.  In this call, the dispatcher asks the caller numerous "non-urgent" questions which significantly delay the recognition of cardiac arrest and the initiation of chest compressions.  The dispatcher should simply ask, "Is the victim breathing normally?" Additionally, the dispatcher also uses the question, "Do you want to start CPR?" instead of using a more assertive phrase such as, "We need to start CPR, I will help you."

Audio file #2 is an example of agonal breathing (or gasping).  Note the irregular and prolonged sound the victim makes with each breath, which is often described as "snoring."  Agonal breathing can sound differently but this is an example that the breathing is not normal.  Most of the time lay rescuers can identify that the breathing of a cardiac arrest victim is NOT normal.

Audio file #3 is an example of very good CPR pre-arrival instructions.  The dispatcher recognizes the cardiac arrest very early in the call and is assertive in the instructions.  The dispatcher instructs the caller to immediately get the victim out of the car and onto a firm surface to initiate compressions.  This is often difficult depending on the size of the victim and the rescuer.  The dispatcher instructs chest compressions only with a very assertive tone.  She asks the question, "Is he breathing normally?"  When the answer is "no" she instructs the caller to continue chest compressions.  Additionally, the dispatcher recognizes agonal breathing and immediately instructs the caller to continue CPR. It is important to remember that sometimes cardiac arrest victims will gasp during CPR and when that occurs, CPR should be continued

Audio file #4 is another example of excellent CPR instructions.  The dispatcher is assertive yet calms the very excited caller.  The dispatcher tells the caller, "I can give you CPR instructions, get the victim on the floor."  The dispatcher also coaches the caller to initiate and continue chest compressions and even makes sure the chest compression rate is at least 100 compressions per minute by having the caller count out loud.  He repetitively tells the caller, "faster, faster."  Importantly, the dispatcher has the caller continue chest compressions up until the time trained rescuers arrive.

Audio file #5 "This recording demonstrates a cardiac arrest victim who initially had movements which were interpreted by the bystander as a seizure.  The victim was also not breathing normally as evident by the audible agonal respirations you can hear on the tape.  The dispatcher quickly recognizes the cardiac arrest scenario and instructs the bystander on how to perform chest compressions.  As she does this, the bystander notes that the victim "begins to breath again."  Then she stops and the victim stops breathing completely.  This is not an uncommon scenario where a cardiac arrest victim will have some movements which are mistaken for seizure activity.  Also, when chest compressions are provided, cardiac arrest victims will often gasp.  When this occurs, unless the victim becomes responsive and has normal breathing, CPR should be continued."