Document Detail


Importance of the first link: description and recognition of an out-of-hospital cardiac arrest in an emergency call.
MedLine Citation:
PMID:  19349324     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The content of emergency calls for suspected cardiac arrest is rarely analyzed. This study investigated the recognition of a cardiac arrest by dispatchers and its influence on survival rates. METHODS AND RESULTS: During 8 months, voice recordings of 14,800 consecutive emergency calls were collected to audit content and cardiac arrest recognition. The presence of cardiac arrest during the call was assessed from the ambulance crew report. Included calls were placed by laypersons on site and did not involve trauma. Prevalence of cardiac arrest was 3.0%. Of the 285 cardiac arrests, 82 (29%) were not recognized during the call, and 64 of 267 suspected calls (24%) were not cardiac arrest. We analyzed a random sample (n=506) of 9230 control calls. Three-month survival was 5% when a cardiac arrest was not recognized versus 14% when it was recognized (P=0.04). If the dispatcher did not recognize the cardiac arrest, the ambulance was dispatched a mean of 0.94 minute later (P<0.001) and arrived 1.40 minutes later on scene (P=0.01) compared with recognized calls. The main reason for not recognizing the cardiac arrest was not asking if the patient was breathing (42 of 82) and not asking to describe the type of breathing (16 of 82). Normal breathing was never mentioned in true cardiac arrest calls. A logistic regression model identified spontaneous trigger words like facial color that could contribute to cardiac arrest recognition (odds ratio, 7.8 to 9.7). CONCLUSIONS: Not recognizing a cardiac arrest during emergency calls decreases survival. Spontaneous words that the caller uses to describe the patient may aid in faster and better recognition of a cardiac arrest.
Authors:
Jocelyn Berdowski; Freerk Beekhuis; Aeilko H Zwinderman; Jan G P Tijssen; Rudolph W Koster
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-04-06
Journal Detail:
Title:  Circulation     Volume:  119     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-04-21     Completed Date:  2009-05-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2096-102     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. J.Berdowski@amc.nl
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Ambulances / statistics & numerical data
Cardiopulmonary Resuscitation / utilization
Communication*
Cues
Death, Sudden, Cardiac / epidemiology,  prevention & control
Diagnostic Errors / prevention & control
Early Diagnosis
Emergencies
Emergency Medical Service Communication Systems / organization & administration*
Emergency Medical Services / organization & administration*,  statistics & numerical data
Female
Heart Arrest / diagnosis*,  mortality,  therapy
Humans
Male
Middle Aged
Netherlands / epidemiology
Prevalence
Prospective Studies
Respiration Disorders / etiology
Sampling Studies
Single-Blind Method
Telephone*
Comments/Corrections
Comment In:
Circulation. 2009 Apr 21;119(15):2023-5   [PMID:  19380632 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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