Challenges in out-of-hospital cardiac arrest – A study combining closed-circuit television (CCTV) and medical emergency calls

Linderoth, Gitte; Hallas, Peter; Lippert, Freddy; Wibrandt, Ida; Loumann, Søren; Møller, Thea Palsgaard; Østergaard, Doris

doi:10.1016/j.resuscitation.2015.06.003

Cited by 48 publications

(50 citation statements)

References 26 publications

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“…Prior studies of OHCA report correct cardiac arrest diagnosis in 15–92% of cases, [3, 4] the overall sensitivity in our study was in the lower range of this at 35%.…”

Section: Discussionsupporting

confidence: 39%

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Effect and accuracy of emergency dispatch telephone guidance to bystanders in trauma: post-hoc analysis of a prospective observational study

Bakke

Steinvik

Ruud

et al. 2017

Scand J Trauma Resusc Emerg Med

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BackgroundEmergency medical communication centres (EMCCs) dispatch and allocate ambulance resources, and provide first-aid guidance to on-scene bystanders. We aimed to 1) evaluate whether dispatcher guidance improved bystander first aid in trauma, and 2) to evaluate whether dispatchers and on-scene emergency medical services (EMS) crews identified the same first aid measures as indicated.MethodsFor 18 months, the crew on the first EMS crew responding to trauma calls used a standard form to assess bystander first aid. Audio recordings of the corresponding telephone calls from bystanders to the EMCC were reviewed.ResultsA total of 311 trauma calls were included. The on-scene EMS crew identified needs for the following first-aid measures: free airway in 26 patients, CPR in 6 patients, and hypothermia prevention in 179 patients. EMCC dispatchers advised these measures, respectively, in 16 (62%), 5 (83%), and 54 (30%) of these cases. Dispatcher guidance was not correlated with correctly performed bystander first aid. For potentially life saving first aid measures, all (20/20) callers who received dispatcher guidance attempted first aid, while only some few (4/22) of the callers who did not receive dispatcher guidance did not attempt first aid.DiscussionOverall, the EMCC dispatchers had low sensitivity and specificity for correctly identifying trauma patients requiring first-aid measures. Dispatcher guidance did not significantly influence whether on-scene bystander first aid was performed correctly or attempted in this study setting, with a remarkably high willingness to perform first-aid. However, the findings for potentially lifesaving measures suggests that there may be differences that this study was unable to detect.ConclusionThis study found a high rate of first-aid willingness and performance, even without dispatcher prompting, and a low precision in dispatcher advice. This underlines the need for further knowledge about how to increase EMCC dispatchers’ possibility to identify trauma patients in need of first aid. The correlation between EMCC-guidance and bystander first aid should be investigated in study settings with lower spontaneous first-aid rates.

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“…Prior studies of OHCA report correct cardiac arrest diagnosis in 15–92% of cases, [3, 4] the overall sensitivity in our study was in the lower range of this at 35%.…”

Section: Discussionsupporting

confidence: 39%

“…Dispatcher guidance reportedly increases the bystander CPR rate following out-of-hospital cardiac arrest (OHCA) [2, 3]. However, dispatchers may have difficulty correctly assessing situations, [3, 4] and no studies have described bystander first-aid guidance in trauma cases.…”

Section: Introductionmentioning

confidence: 99%

Effect and accuracy of emergency dispatch telephone guidance to bystanders in trauma: post-hoc analysis of a prospective observational study

Bakke

Steinvik

Ruud

et al. 2017

Scand J Trauma Resusc Emerg Med

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“…On the other hand, resuscitation team organization may be different during national meeting dates compared to nonmeeting dates, as many medical personnel attend the relevant meetings. A team approach with strong leadership during resuscitation has been reported to be associated with better outcomes in patients after OHCA as well as in-hospital cardiac arrest [22,23]. Our results suggest that there would be a small impact on patient outcomes as a "post-meeting effect" as such a short time period [3].…”

Section: Discussionmentioning

confidence: 67%

Geographical Differences and the National Meeting Effect in Patients with Out-of-Hospital Cardiac Arrests: A JCS–ReSS Study Report

Yumoto

Naito

Yorifuji

et al. 2019

IJERPH

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The “national meeting effect” refers to worse patient outcomes when medical professionals attend academic meetings and hospitals have reduced staffing. The aim of this study was to examine differences in outcomes of patients with out-of-hospital cardiac arrest (OHCA) admitted during, before, and after meeting days according to meeting location and considering regional variation of outcomes, which has not been investigated in previous studies. Using data from a nationwide, prospective, population-based, observational study in Japan, we analyzed adult OHCA patients who underwent resuscitation attempts between 2011 and 2015. Favorable one-month neurological outcomes were compared among patients admitted during the relevant annual meeting dates of three national scientific societies, those admitted on identical days the week before, and those one week after the meeting dates. We developed a multivariate logistic regression model after adjusting for confounding factors, including meeting location and regional variation (better vs. worse outcome areas), using the “during meeting days” group as the reference. A total of 40,849 patients were included in the study, with 14,490, 13,518, and 12,841 patients hospitalized during, before, and after meeting days, respectively. The rates of favorable neurological outcomes during, before, and after meeting days was 1.7, 1.6, and 1.8%, respectively. After adjusting for covariates, favorable neurological outcomes did not differ among the three groups (adjusted OR (95% CI) of the before and after meeting dates groups was 1.03 (0.83–1.28) and 1.01 (0.81–1.26), respectively. The “national meeting effect” did not exist in OHCA patients in Japan, even after comparing data during, before, and after meeting dates and considering meeting location and regional variation.

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“…Linderoth et al (2015) state that we should think of the dispatcher and bystander as "the first resuscitation team" at the scene. Linderoth et al (2015) state that we should think of the dispatcher and bystander as "the first resuscitation team" at the scene.…”

Section: Introductionmentioning

confidence: 99%

“…Thus, the public may be unaware of the extent of support offered by dispatchers during OHCA incidents. Linderoth et al (2015) state that we should think of the dispatcher and bystander as "the first resuscitation team" at the scene. However, we do not know whether bystanders share this team concept, nor if the knowledge and expectations about dispatcher assistance in OHCA incidents are well known.…”

Section: Introductionmentioning

confidence: 99%

Public knowledge and expectations about dispatcher assistance in out‐of‐hospital cardiac arrest

Mathiesen

Birkenes

Lund

et al. 2018

Journal of Advanced Nursing

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Aim To assess the factors associated with the knowledge and expectations among the general public about dispatcher assistance in out‐of‐hospital cardiac arrest incidents. Background In medical dispatch centres, emergency calls are frequently operated by specially trained nurses as dispatchers. In cardiac arrest incidents, efficient communication between the dispatcher and the caller is vital for prompt recognition and treatment of the cardiac arrest. Design A cross‐sectional observational survey containing six questions and seven demographic items. Method From January–June 2017 we conducted standardized interviews among 500 members of the general public in Norway. In addition to explorative statistical methods, we used multivariate logistic analysis. Results Most participants expected cardiopulmonary resuscitation instructions, while few expected “help in deciding what to do.” More than half regarded the bystanders present to be responsible for the decision to initiate cardiopulmonary resuscitation. Most participants were able to give the correct emergency medical telephone number. The majority knew that the emergency call would not be terminated until the ambulance arrived at the scene. However, only one‐third knew that the emergency telephone number operator was a trained nurse. Conclusion The public expect cardiopulmonary resuscitation instructions from the emergency medical dispatcher. However, the majority assume it is the responsibility of the bystanders to make the decision to initiate cardiopulmonary resuscitation or not. Based on these findings, cardiopulmonary resuscitation training initiatives and public campaigns should focus more on the role of the emergency medical dispatcher as the team leader of the first resuscitation team in cardiac arrest incidents.

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Challenges in out-of-hospital cardiac arrest – A study combining closed-circuit television (CCTV) and medical emergency calls

Cited by 48 publications

References 26 publications

Effect and accuracy of emergency dispatch telephone guidance to bystanders in trauma: post-hoc analysis of a prospective observational study

Effect and accuracy of emergency dispatch telephone guidance to bystanders in trauma: post-hoc analysis of a prospective observational study

Geographical Differences and the National Meeting Effect in Patients with Out-of-Hospital Cardiac Arrests: A JCS–ReSS Study Report

Public knowledge and expectations about dispatcher assistance in out‐of‐hospital cardiac arrest

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