Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Curtin University, Bentley, WA 6102, Australia.
Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Curtin University, Bentley, WA 6102, Australia.
Resuscitation. 2021 Dec;169:105-112. doi: 10.1016/j.resuscitation.2021.10.035. Epub 2021 Oct 27.
One-fifth of Australia's population do not speak English at home. International studies have found emergency calls with language barriers (LB) result in longer delays to out-of-hospital cardiac arrest (OHCA) recognition, and lower rates of bystander cardiopulmonary resuscitation (CPR) and survival. This study compared LB and non-LB OHCA call time intervals in an Australian emergency medical service (EMS).
The retrospective cohort study measured time intervals from call commencement for primary outcomes: (1) address acquisition; (2) OHCA recognition; (3) CPR initiation; (4) telecommunicator CPR (t-CPR) compressions, in all identified LB calls and a 2:1 random sample of non-LB EMS calls from January to June 2019. Results for time intervals #1, 2, and 4 were benchmarked against the American Heart Association's (AHA) t-CPR minimal acceptable time standards. Patient survival outcomes were compared.
We identified 50 (14%) LB calls from a cohort of 353 calls. LB calls took longer than non-LB calls (n=100) for: address acquisition (median 29 vs 14 secs, p<0.001), OHCA recognition (103 vs 85 secs, p=0.02), and CPR initiation (206 vs 164 secs, p=0.01), but not for t-CPR compressions (292 vs 248 secs, p=0.12). Rates of OHCA recognition and 30-day-survival did not differ but smaller proportions of LB calls met the AHA standards.
Time delays found in LB calls point to phases of the call which need further qualitative investigation to understand how to improve communication. Overall, training call-takers for LB calls may assist caller understanding and cooperation during OHCAs.
澳大利亚有五分之一的人在家不说英语。国际研究发现，有语言障碍的紧急呼叫会导致院外心脏骤停（OHCA）的识别延迟更长时间，旁观者心肺复苏（CPR）和生存的比例更低。本研究比较了澳大利亚紧急医疗服务（EMS）中存在语言障碍（LB）和不存在语言障碍（非 LB）的 OHCA 呼叫时间间隔。
回顾性队列研究测量了从呼叫开始的时间间隔，主要结果为：（1）地址获取；（2）OHCA 识别；（3）CPR 启动；（4）在 2019 年 1 月至 6 月期间，所有识别的 LB 呼叫和非 LB EMS 呼叫的 2:1 随机样本中的远程通讯 CPR（t-CPR）按压。时间间隔 #1、2 和 4 的结果与美国心脏协会（AHA）的 t-CPR 最小可接受时间标准进行了基准测试。比较了患者的生存结果。
我们从 353 个呼叫的队列中识别出 50 个（14%）LB 呼叫。LB 呼叫比非 LB 呼叫（n=100）需要更长的时间：地址获取（中位数 29 秒对 14 秒，p<0.001），OHCA 识别（103 秒对 85 秒，p=0.02）和 CPR 启动（206 秒对 164 秒，p=0.01），但 t-CPR 按压（292 秒对 248 秒，p=0.12）则不然。OHCA 识别和 30 天生存率没有差异，但符合 AHA 标准的 LB 呼叫比例较小。
LB 呼叫中的时间延迟表明呼叫的某些阶段需要进一步进行定性研究，以了解如何改善沟通。总体而言，对 LB 呼叫的呼叫者进行培训可能有助于在 OHCA 期间提高呼叫者的理解和合作。
