Resuscitation
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We sought to determine if, in patients with out-of-hospital cardiac arrest (OHCA), the description of any specific symptoms to the emergency medical dispatcher (EMD) improved the accuracy of the diagnosis of cardiac arrest. ⋯ Dispatchers should recognize cardiac arrest when a victim is described as unconscious and not breathing or not breathing normally, and consider cardiac arrest when generalized seizure is described. They should receive specific instructions on how to best recognize the presence of abnormal breathing.
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Early bystander cardiopulmonary resuscitation (CPR) provides an essential bridge to successful defibrillation from sudden cardiac arrest (SCA) and there is a need to increase the prevalence and quality of bystander CPR. Emergency medical dispatchers can give CPR instructions to a bystander calling for an ambulance enabling even an inexperienced bystander to start CPR. The impact of these instructions has not been evaluated. ⋯ There is limited evidence supporting the survival benefit of dispatch-assisted CPR instructions. All studies comparing survival outcomes when CPR is provided with or without the assistance of dispatch-assisted CPR instructions lack the statistical power to draw significant conclusions. Since it has been demonstrated that such instructions can improve bystander CPR rates, it is reasonable to recommend they should be provided to all callers reporting a victim in cardiac arrest.
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Early bystander cardiopulmonary resuscitation (CPR) provides an essential bridge to successful defibrillation from sudden cardiac arrest (SCA) and there is a need to increase the prevalence and quality of bystander CPR. Emergency medical dispatchers can give CPR instructions to a bystander calling for an ambulance enabling even an inexperienced bystander to start CPR. The impact of these instructions has not been evaluated. ⋯ There is limited evidence supporting the survival benefit of dispatch-assisted CPR instructions. All studies comparing survival outcomes when CPR is provided with or without the assistance of dispatch-assisted CPR instructions lack the statistical power to draw significant conclusions. Since it has been demonstrated that such instructions can improve bystander CPR rates, it is reasonable to recommend they should be provided to all callers reporting a victim in cardiac arrest.
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As a part of the chain of survival, the emergency medical communication centre (EMCC) and the emergency medical dispatcher (EMD) has an important role in early identification of out-of-hospital cardiac arrests (OHCA). The EMD may provide instructions to the caller and thereby initiate cardiopulmonary resuscitation in a substantial number of subjects and thus contribute to increased survival. The EMCC provides a response with first responders, ambulances, physician manned units and potentially other health care providers. ⋯ In research there is a growing focus on the EMCC/EMDs impact on survival in OHCA. The lack of standards in reporting results from medical dispatching is an obstacle for thorough evaluation of results in this area and comparison of data. The objective for this paper is to introduce a framework for uniform reporting of the dispatching process for quality improvement, collecting and reporting data and exchanging information regarding OHCA.