Dispatcher Assistance in Out-of-hospital Cardiac Arrest: Approaches for Diagnosing Cardiac Arrest by Telephone
https://doi.org/10.23934/2223-9022-2019-8-1-60-67
Abstract
Rapid recognition of cardiac arrest based on the data reported by a bystander, and delivering telephone cardiopulmonary resuscitation instructions by emergency medical services (EMS) dispatcher promote timely provision of frst aid by people who witness the emergency, and this may signifcantly influence the outcome of out-of-hospital cardiac arrest (OHCA). This review is aimed to analyze the up-to-date scientifc literature on EMS dispatcher recognition of OHCA. In particular, general concept and experience of algorithm-based diagnosis of cardiac arrest, diffculties of telephone OHCA recognition, approaches for dispatcher diagnosis quality evaluation and assurance are discussed herein. Based on the analysis results, recommendations on organizing and improving the effectiveness of EMS dispatcher recognition of cardiac arrest are formulated. The review is designed primarily for EMS and public health specialists.
About the Authors
A. A. Birkun
Medical Academy named after S.I. georgievsky of V.I. Vernadsky Crimean Federal university
Russian Federation
Russian Federation
Aleksei A. Birkun – Cand. Med. Sci., Assistant Professor of the Department of Anaesthesiology, Resuscitation and Emergency Medicine
5/7 Lenin Blvd, Simferopol 295006
L. I. Dezhurny
Central Research Institute for Health Organization and Information System Development of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Leonid I. Dezhurny – Dr. Med. Sci., Chief Researcher
11 Dobrolubova St., Moscow 127254
References
1. Castrén M., Bohm K., Kvam A.M., et al. Reporting of data from out-ofhospital cardiac arrest has to involve emergency medical dispatching — taking the recommendations on reporting OHCA the Utstein style a step further. Resuscitation. 2011; 82(12): 1496–1500. PMID: 21907688. DOI: 10.1016/j.resuscitation.2011.08.020.
2. Nolan J., Soar J., Eikeland H. The chain of survival. Resuscitation. 2006; 71(3): 270–271. PMID: 17070646. DOI: 10.1016/j.resuscitation.2006.09.001.
3. Perkins G.D., Handley A.J., Koster R.W., et al. European Resuscitation Council Guidelines for Resuscitation 2015: Section 2. Adult basic life support and automated external defibrillation. Resuscitation. 2015; 95: 81–99. PMID: 26477420. DOI: 10.1016/j.resuscitation.2015.07.015.
4. Heward A., Damiani M., Hartley-Sharpe C. Does the use of the Advanced Medical Priority Dispatch System affect cardiac arrest detection? Emerg Med J. 2004; 21(1): 115–118. PMID: 14734398. PMCID: PMC1756371.
5. Kuisma M., Boyd J., Väyrynen T., et al. Emergency call processing and survival from out-of-hospital ventricular fibrillation. Resuscitation. 2005; 67(1): 89–93. PMID: 16129542. DOI: 10.1016/j.resuscitation.2005.04.008
6. Berdowski J., Beekhuis F., Zwinderman A.H., et al. Importance of the first link: description and recognition of an out-of-hospital cardiac arrest in an emergency call. Circulation. 2009; 119(15): 2096–2102. PMID: 19349324. DOI: 10.1161/CIRCULATIONAHA.108.768325.
7. Viereck S., Møller T.P., Rothman J.P., et al. Recognition of out-ofhospital cardiac arrest during emergency calls – a systematic review of observational studies. Scand J Trauma Resusc Emerg Med. 2017; 25(1): 9. PMID: 28143588 PMCID: PMC5286832. DOI: 10.1186/s13049-017-0350-8.
8. Lewis M., Stubbs B.A., Eisenberg M.S. Dispatcher-assisted cardiopulmonary resuscitation: time to identify cardiac arrest and deliver chest compression instructions. Circulation. 2013; 128(14): 1522–1530. PMID: 23983252. DOI: 10.1161/CIRCULATIONAHA.113.002627.
9. Plodr M., Truhlar A., Krencikova J., et al. Effect of introduction of a standardized protocol in dispatcher-assisted cardiopulmonary resuscitation. Resuscitation. 2016; 106: 18–23. PMID: 27327229. DOI: 10.1016/j.resuscitation.2016.05.031.
10. Carter W.B., Eisenberg M.S., Hallstrom A.P., Schaeffer S. Development and implementation of emergency CPR instruction via telephone. Ann Emerg Med. 1984; 13(9 Pt. 1): 695–700. PMID: 6465650.
11. Eisenberg M.S., Hallstrom A.P., Carter W.B., et al. Emergency CPR instruction via telephone. Am J Public Health. 1985; 75(1): 47–50. PMID: 3966598. PMCID: PMC1646147.
12. Hiltunen P.V., Silfvast T.O., Jäntti T.H., et al. Emergency dispatch process and patient outcome in bystander-witnessed out-of-hospital cardiac arrest with a shockable rhythm. Eur J Emerg Med. 2015; 22(4): 266–272. PMID: 24809817. PMCID: PMC4530730. DOI: 10.1097/MEJ.0000000000000151.
13. Oman G., Bury G. Use of telephone CPR advice in Ireland: Uptake by callers and delays in the assessment process. Resuscitation. 2016; 102: 6–10. PMID: 26898413. DOI: 10.1016/j.resuscitation.2016.02.006.
14. Hallstrom A.P., Cobb L.A., Johnson E., Copass M.K. Dispatcher assisted CPR: implementation and potential benefit. A 12-year study. Resuscitation. 2003; 57(2): 123–129. PMID: 12745179.
15. Ho A.F., Sim Z.J., Shahidah N., et al. Barriers to dispatcher-assisted cardiopulmonary resuscitation in Singapore. Resuscitation. 2016; 105: 149–155. PMID: 27288652. DOI: 10.1016/j.resuscitation.2016.05.006.
16. Vaillancourt C., Charette M.L., Bohm K., et al. In out-of-hospital cardiac arrest patients, does the description of any specific symptoms to the emergency medical dispatcher improve the accuracy of the diagnosis of cardiac arrest: a systematic review of the literature. Resuscitation. 2011; 82(12): 1483–1489. PMID: 21704442. DOI: 10.1016/j.resuscitation.2011.05.020.
17. Tanaka Y., Nishi T., Takase K., et al. Survey of a protocol to increase appropriate implementation of dispatcher-assisted cardiopulmonary resuscitation for out-of-hospital cardiac arrest. Circulation. 2014; 129(17): 1751–1760. PMID: 24508824. DOI: 10.1161/CIRCULATIONAHA.113.004409.
18. Hardeland C., Olasveengen T.M., Lawrence R., et al. Comparison of Medical Priority Dispatch (MPD) and Criteria Based Dispatch (CBD) relating to cardiac arrest calls. Resuscitation. 2014; 85(5): 612–616. PMID: 24525117. DOI: 10.1016/j.resuscitation.2014.01.029.
19. Besnier E., Damm C., Jardel B., et al. Dispatcher-assisted cardiopulmonary resuscitation protocol improves diagnosis and resuscitation recommendations for out-of-hospital cardiac arrest. Emerg Med Australas. 2015; 27(6): 590–596. PMID: 26449723. DOI: 10.1111/1742-6723.12493.
20. Hauff S.R., Rea T.D., Culley L.L., et al. Factors impeding dispatcherassisted telephone cardiopulmonary resuscitation.Ann Emerg Med. 2003; 42(6): 731–737. PMID: 14634595. DOI: 10.1016/S0196064403004232.
21. Vaillancourt C., Verma A., Trickett J., et al. Evaluating the effectiveness of dispatch-assisted cardiopulmonary resuscitation instructions. Acad Emerg Med. 2007; 14(10): 877–883. PMID: 17761545. DOI: 10.1197/j.aem.2007.06.021.
22. Bohm K., Stålhandske B., Rosenqvist M., et al. Tuition of emergency medical dispatchers in the recognition of agonal respiration increases the use of telephone assisted CPR. Resuscitation. 2009; 80(9): 1025– 1028. PMID: 19581043. DOI: 10.1016/j.resuscitation.2009.06.004.
23. Bobrow B.J., Zuercher M., Ewy G.A., et al. Gasping during cardiac arrest in humans is frequent and associated with improved survival. Circulation. 2008; 118(24): 2550–2554. PMID: 19276800. DOI: 10.1161/CIRCULATIONAHA.108.799940.
24. Bohm K., Rosenqvist M., Hollenberg J., et al. Dispatcher-assisted telephone-guided cardiopulmonary resuscitation: an underused lifesaving system. Eur J Emerg Med. 2007; 14(5): 256–259. PMID: 17823559. DOI: 10.1097/MEJ.0b013e32823a3cd1.
25. Roppolo L.P., Westfall A., Pepe P.E., et al. Dispatcher assessments for agonal breathing improve detection of cardiac arrest. Resuscitation. 2009; 80(7): 769–772. PMID: 19477058. DOI: 10.1016/j.resuscitation.2009.04.013.
26. Travers S., Jost D., Gillard Y., et al. Out-of-hospital cardiac arrest phone detection: those who most need chest compressions are the most difficult to recognize. Resuscitation. 2014; 85(12): 1720–1725. PMID: 25281907. DOI: 10.1016/j.resuscitation.2014.09.020.
27. Bobrow B.J., Panczyk M., Subido C. Dispatch-assisted cardiopulmonary resuscitation: the anchor link in the chain of survival. Curr Opin Crit Care. 2012; 18(3): 228–233. PMID: 22334216. DOI: 10.1097/MCC.0b013e328351736b.
28. Hardeland C., Skåre C., Kramer-Johansen J., et al. Targeted simulation and education to improve cardiac arrest recognition and telephone assisted CPR in an emergency medical communication centre. Resuscitation. 2017; 114: 21–26. PMID: 28236428. DOI: 10.1016/j.resuscitation.2017.02.013.
29. Krischer J.P., Fine E.G., Davis J.H., Nagel E.L. Complications of cardiac resuscitation. Chest. 1987; 92(2): 287–291. PMID: 3608599.
30. White L., Rogers J., Bloomingdale M., et al. Dispatcher-assisted cardiopulmonary resuscitation: risks for patients not in cardiac arrest. Circulation. 2010; 121(1): 91–97. PMID: 20026780. DOI: 10.1161/CIRCULATIONAHA.109.872366.
31. Gijsenbergh F., Nieuwenhof A., Machiels K. Improving the first link in the chain of survival: the Antwerp experience. Eur J Emerg Med. 2003; 10(3): 189–194. PMID: 12972893. DOI: 10.1097/01.mej.0000088430.19737.b1.
32. Tanaka Y., Taniguchi J., Wato Y., et al. The continuous quality improvement project for telephone-assisted instruction of cardiopulmonary resuscitation increased the incidence of bystander CPR and improved the outcomes of out-of-hospital cardiac arrests. Resuscitation. 2012; 83(10): 1235–1241. PMID: 22366353. DOI: 10.1016/j.resuscitation.2012.02.013.
33. Tsunoyama T., Nakahara S., Yoshida M., et al. Effectiveness of dispatcher training in increasing bystander chest compression for out-of-hospital cardiac arrest patients in Japan. Acute Med Surg. 2017; 4(4): 439–445. PMID: 29123905. PMCID: PMC5649305. DOI: 10.1002/ams2.303.
34. Meischke H., Painter I.S., Stangenes S.R., et al. Simulation training to improve 9-1-1 dispatcher identification of cardiac arrest: A randomized controlled trial. Resuscitation. 2017; 119: 21–26. PMID: 28760696. DOI: 10.1016/j.resuscitation.2017.07.025.
35. Bol’shakova I.A., Kucherenko M.A., Samarina V.Yu., Kovalevskiy D.V. The role of the ambulance service in the framework of the unified concept of elimination of consequences of road accidents in the Novosibirsk region. In: Bagnenko S.F., ed. Ambulance-2017: proceedings of the 16th all-Russian Congress (scientific and practical conference with international participation), dedicated to the 85th anniversary of I. I. Dzhanelidze St. Petersburg Research Institute of Emergency Care and the 35th anniversary of the Department of emergency medical care of the North-West State Medical University. I. I. Mechnikova, (Saint Petersburg, 8–9 June 2017). Saint Petersburg: PSPbGMU im. I.P. Pavlova Publ., 2017: 18–20. (In Russian).
36. Avdeyeva V.G., Balakhontsev A.P., Fedotkin O.V. Perspective directions of activity of territorial disaster medical center of the Perm region. Tikhookeanskiy meditsinskiy zhurnal. 2007; (1): 84–89. (In Russian).
37. Order of the Ministry of health of the Russian Federation of 20.06.2013 No 388n (ed. from 05.05.2016) “On approval of the procedure for the provision of emergency, including emergency specialized medical care. Available at: http://base.garant.ru/70438200. (Accessed 17 Aug 2018) (In Russian).
38. Order of the Ministry of health of the Russian Federation of 10.02.2016 No 83n “On approval of Qualification requirements for medical and pharmaceutical workers with secondary medical and pharmaceutical education”. Available at: http://www.garant.ru/products/ipo/prime/doc/71248254. (Accessed 17 Aug 2018) (In Russian).
39. Birkun A., Kosova Y. Social attitude and willingness to attend cardiopulmonary resuscitation training and perform resuscitation in the Crimea. World J Emerg Med. 2018; 9(4): 237–248. DOI: 10.5847/wjem.j.1920-8642.2018.04.001
40. Shumatov V.B., Kuznetsov V.V., Lebedev S.V. Effective cardio-pulmonary pesuscitation on pre-hospital stage: basic elements, experience of introduction. Tikhookeanskiy meditsinskiy zhurnal. 2006; (1): 81–84. (In Russian).
41. Birkun A.A., Glotov M.A. Epidemiological features of out-of-hospital cardiac arrest: evidence from particular administrative centre in Russian Federation. Anesteziologiya i reanimatologiya. 2017; 62(2): 113–117. (In Russian).
Review
For citations:
Birkun A.A., Dezhurny L.I. Dispatcher Assistance in Out-of-hospital Cardiac Arrest: Approaches for Diagnosing Cardiac Arrest by Telephone. Russian Sklifosovsky Journal "Emergency Medical Care". 2019;8(1):60-67. https://doi.org/10.23934/2223-9022-2019-8-1-60-67
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