Department of Emergency Medicine, University of Florida, 1329 SW 16th Street, P.O. Box 100186, Gainesville, FL 32610, United States.
Department of Emergency Medicine, University of Florida, 1329 SW 16th Street, P.O. Box 100186, Gainesville, FL 32610, United States.
Am J Emerg Med. 2022 Apr;54:127-130. doi: 10.1016/j.ajem.2022.01.068. Epub 2022 Feb 5.
Immediate recognition of out-of-hospital cardiac arrest (OHCA) by Emergency Medical Dispatch (EMD) operators is crucial to facilitate timely initiation of telephone cardiopulmonary resuscitation (T-CPR) and to enable the appropriate level of Emergency Medical Services (EMS) response. The goal of this study was to identify patterns that can increase EMD-level recognition of cardiac arrests prior to EMS arrival.
The Combined Communications Center in Alachua County, Florida provided audio recordings of all emergency calls from January 1, 2018 to November 16, 2018 dispatched as a chief complaint other than OHCA, but later identified as cardiac arrest. A multi-disciplinary medical team transcribed and analyzed the calls to determine common themes and trends.
Out of an initial 81 calls meeting inclusion criteria, 69 were immediately recognized as OHCA by EMDs, leaving 12 calls of unrecognized OHCA. In 11 of 12 calls respiratory issues were described to EMD. In 10 of 12 calls the subject was described as unconscious, and in the other 2 calls, the subject lost consciousness during the call.
Lack of recognition of OHCA by EMD occurred in most calls due to difficulty communicating the subject's respiratory status. Further emphasis should be placed on identifying non-viable respirations in unconscious patients in EMD training and algorithms to increase recognition of OHCA and initiation of T-CPR. A multi-year review of a comparable dataset from geographically and socioeconomically diverse regions in the United States can validate and expand these preliminary trends.
紧急医疗调度（EMD）人员对院外心脏骤停（OHCA）的即时识别对于促进及时开始电话心肺复苏（T-CPR）和启用适当水平的紧急医疗服务（EMS）响应至关重要。本研究的目的是确定可以提高 EMD 对 EMS 到达前心脏骤停的识别模式。
佛罗里达州阿拉楚阿县的联合通信中心提供了 2018 年 1 月 1 日至 2018 年 11 月 16 日所有非 OHCA 主要投诉但后来确定为心脏骤停的紧急电话的录音。一个多学科医疗团队对这些电话进行了转录和分析，以确定常见的主题和趋势。
在最初符合纳入标准的 81 个电话中，有 69 个被 EMD 立即识别为 OHCA，留下 12 个未被识别的 OHCA 电话。在 12 个电话中的 11 个中，向 EMD 描述了呼吸问题。在 12 个电话中的 10 个中，主题被描述为无意识，而在另外 2 个电话中，主题在通话期间失去了意识。
由于难以沟通主题的呼吸状况，大多数 EMD 未能识别 OHCA。在 EMD 培训和算法中，应进一步强调识别无意识患者的无生命呼吸，以提高 OHCA 的识别和 T-CPR 的启动。对来自美国地理和社会经济多样化地区的可比数据集进行多年回顾，可以验证和扩展这些初步趋势。
