e132 Abstracts / Resuscitation 130S (2018) e28–e145 could potentially save lives. All EMS in Japan should try to fast EMS arrive even for a minute. https://doi.org/10.1016/j.resuscitation.2018.07.281 AP240 Variation in do not attempt cardiopulmonary resuscitation orders and emergency care and treatment plan use in English acute hospitals: A national survey Claire Hawkes 1,∗ , Keith Couper 1 , James Griffin 1 , Emma Skilton 1 , Gavin Perkins 1,2 1 University of Warwick, Coventry, United Kingdom 2 Heart of England NHS Foundation Trust, Birmingham, United Kingdom Purpose of the study: Variation in the recording of DNACPR decisions between healthcare organisations creates policy and communication challenges when patients are transferred between organisations [1,2]. A recent UK study identified the need for a nationwide system to record resuscitation decisions alongside other treatment escalation decisions [2]. The development of the UK-based Recommended Summary for Emergency care and Treat- ment Plan (ReSPECT) process was a response to this need [3]. ReSPECT has been available to healthcare organisations to adoption since Spring 2017. The purpose of this study was to record current variation in the way in which DNACPR decisions are recorded in UK hospitals and identify the current uptake of the ReSPECT process. Materials and methods: We conducted an online survey between October 2017 and March 2018 of all UK adult NHS hos- pitals participating in the National Cardiac Arrest Audit (NCAA). Descriptive statistics were used to report the results. Results: Of the 187 hospitals surveyed, 114 (61%) responded. Most hospitals reported using a DNACPR form (n = 57, 50%). Other hospitals used either a DNACPR form with separate treatment esca- lation plan (n = 35, 31%), an ECTP or DNACPR form combined with a treatment escalation plan (n = 20, 18%), or another system (n = 2, 2%). In total, 8 hospitals (7%) were using the ReSPECT system. Conclusions: There is variation in the way in which DNACPR decisions are recorded in UK hospitals. To date, only a small number of hospitals have implemented the ReSPECT process. References [1] Freeman K, et al. Variation in local trust Do Not Attempt Cardiopulmonary Resus- citation (DNACPR) policies: a review of 48 English healthcare trusts. BMJ Open 2015;5:e006517. [2] Perkins GD, et al. Do Not Attempt Cardiopulmonary Resusitation (DNACPR) Deci- sions: Evidence Synthesis. Health Services and Delivery Research. NIHR J Lib 2016;4:11. [3] ReSPECT Process website. https://www.respectprocess.org.uk accessed 8.5.18. https://doi.org/10.1016/j.resuscitation.2018.07.282 AP241 Impact of European Emergency Number (112) in out of hospital Cardiac Arrest: Trieste experience Giuseppe Davide Caggegi 1 , Carlo Pegani 1 , Perla Rossini 1,∗ , Michele Zuliani 1 , Erik Roman Pognuz 1 , Davide Durì 2 , Matteo Danielis 3 , Alberto Peratoner 1 1 Struttura Semplice Dipartimentale118, Dipartimento Emergenza Urgenza ed Accettazione, Azienda Sanitaria Universitaria Integrata di Trieste, Trieste, Italy 2 Anestesia e Rianimazione 1, Dipartimento di Anestesia e Rianimazione, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy 3 Anestesia e Rianimazione 2, Dipartimento di Anestesia e Rianimazione, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy Purpose: Accordingly to the EU’s Health Regulatory Framework, the European Emergency Number (112) has been instituted in the city of Trieste since 4th April 2017, possibly leading to changes in the response of the out of hospital emergency system. Aim of the our study is to compare OHCA data between one year before and year after 112 activation. Materials and methods: We analyzed OHCA data collected in the Italian Registry for Cardiac Arrest (RIAC) database by EMS of Trieste between April 4th, 2016, to April 3rd, 2018. Chi-squared test was used to compare data. A P value of < 0.05 was considered significant. Results: Between Pre-112 (208 pt) (A) and Post-112 (206 pt) (B) group, mean age was 80 yo (69-87 (A), 68-88 (B), p = 0.74); male sex was slightly predominant in both groups (59.61% vs 55.34%, p = 0.48). Incidence of witnessed OHCA was similar (67.78% vs 65.53%, p = 0.67). On-line CPR improved after 112 institution (16.34% vs 44.66%, p = <0.001) as the bystander CPR (21.15% vs 50.48%, P = <0.001). Time from dispatch to arrival was 10 minutes mean for both groups (7-13 vs 8-14, p = 0.057); when adding to group (B) the time of call processing by the 112 (90 seconds mean according to official data), a difference between the two groups appears (10 vs 11.5, p < 0.001). The presentation rythm was shock- able in 33 cases (A) vs 30 (B) (15.86% vs 14.56%, p = 0.78). Time to CPR withdrawal was 37 minutes (A, 27.5-50 ′ ) vs 34 minutes (B, 24.5-47 ′ , p = 0.03). 25 attempts of resuscitations resulted in ROSC in both groups (12.01% vs 12.13%, p = 1.0). Conclusions: 112 brought a statistically significative improve- ment in on-line-CPR with higher incidence of bystander CPR, but also an increasing in intervention time by EMS. Nevertheless, rate of ROSC still remains similar. https://doi.org/10.1016/j.resuscitation.2018.07.283