Cardiac arrest recognition and telephone CPR by emergency medical dispatchers

Abstract

Emergency Medical Service (EMS) systems annually encounters about 275 000 out-of-hospital cardiac arrest (OHCA) patients in Europe and approximately 420,000 cases in the United States.1 Survival rates have been reported to be poor with approximately 10% survival to hospital discharge.2 The chance of surviving from an OHCA is highly associated with Emergency Medical Dispatchers’ (EMD) recognition of cardiac arrest, early bystander cardiopulmonary resuscitation (CPR), and early defibrillation.3-6 This study was a simulation based study. All emergency nurses who were eligible by training to answer 112 calls and activate the EMS were included in this study. The simulations were run by two experienced ED nurses who followed predefined scripts. The two key questions that the authors were after included ascertaining patient responsiveness and breathing status. EMDs who offered telephone assisted CPR (tCPR) were noted and observed. The mean percentage recognition of out of hospital cardiac arrest by the Maltese EMDs was 67%. 28% of EMDs who recognized cardiac arrest asked both questions regarding patient’s responsiveness and breathing whilst only 8% of EMDs who did not recognize cardiac arrest asked both questions. The mean percentage of telephone assisted CPR was 58%. Conclusion: When compared to other European countries, OHCA recognition by Maltese EMDs needs to improve. However, given that the local EMDs have no formal guidelines or algorithms for their use during 112 calls, results are encouraging to say the least especially in telephone assisted CPR. With educatio