Stangenes Scott R, Painter Ian S, Rea Thomas D, Meischke Hendrika
Department of Health Services, University of Washington, Seattle, WA, United States.
Department of Medicine, University of Washington, Seattle, WA, United States.
Resuscitation. 2020 Apr;149:82-86. doi: 10.1016/j.resuscitation.2020.02.013. Epub 2020 Feb 20.
The objective of this study was to test if caller descriptions of chief complaint delays emergency medical dispatchers' (EMDs) recognition of the need for telephone-assisted CPR (T-CPR).
We conducted an analysis of N = 433 cardiac arrest calls from six large call centers in the United States. Calls were abstracted for initial chief complaint description: caller reports (1) correct medical condition (CMC); (2) incorrect medical condition (IMC), or (3) signs/symptoms only (SS), as well the time interval between call pickup and recognition of the need for T-CPR. In addition, we abstracted if EMDs asked questions related to the caller's chief complaint (rather than, or before), asking about patients' consciousness and breathing status.
The majority of cardiac arrest calls (60%) were reported as SS. Median time to recognition of the need for T-CPR was 64 s for SS chief complaints, 47 s for CMC chief complaints, and 100 s for IMC chief complaints. EMDs pursued chief complaint descriptions for 9% of the calls with SS chief complaints, 41% of the calls with IMC chief complaints, and 19% of the calls with CMC chief complaints. Median time to recognition of the need for CPR for calls in which the chief complaint description was pursued was 166 s compared to 62 s for calls in which the chief complaint description was not pursued.
Caller chief complaint description affects the time to recognition of the need for T-CPR.
http://www.clinicaltrials.gov Trial # NCT01972087.
本研究的目的是测试来电者对主要症状的描述是否会延迟急救医疗调度员(EMD)识别电话辅助心肺复苏(T-CPR)的需求。
我们对来自美国六个大型呼叫中心的N = 433例心脏骤停呼叫进行了分析。提取呼叫的初始主要症状描述:来电者报告(1)正确的医疗状况(CMC);(2)错误的医疗状况(IMC),或(3)仅体征/症状(SS),以及从接听电话到识别T-CPR需求的时间间隔。此外,我们提取了EMD是否询问了与来电者主要症状相关的问题(而不是在询问患者意识和呼吸状态之前)。
大多数心脏骤停呼叫(60%)报告为仅体征/症状。对于仅体征/症状的主要症状,识别T-CPR需求的中位时间为64秒,对于正确医疗状况的主要症状为47秒,对于错误医疗状况的主要症状为100秒。对于9%的仅体征/症状主要症状的呼叫、41%的错误医疗状况主要症状的呼叫和19%的正确医疗状况主要症状的呼叫,EMD询问了主要症状描述。对于询问主要症状描述的呼叫,识别心肺复苏需求的中位时间为166秒,而对于未询问主要症状描述的呼叫为62秒。
来电者主要症状描述会影响识别T-CPR需求的时间。
http://www.clinicaltrials.gov 试验编号:NCT01972087。