Richards Christopher T, McCarthy Danielle M, Markul Eddie, Rottman Doreen R, Lindeman Patricia, Prabhakaran Shyam, Klabjan Diego, Holl Jane L, Cameron Kenzie A
Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Emergency Medicine, Northwestern Feinberg School of Medicine, Chicago, IL, USA; Chicago EMS System, Chicago, IL, USA.
Department of Emergency Medicine, Northwestern Feinberg School of Medicine, Chicago, IL, USA.
Patient Educ Couns. 2022 Jul;105(7):2130-2136. doi: 10.1016/j.pec.2022.03.004. Epub 2022 Mar 5.
Recognition of out-of-hospital cardiac arrest (OHCA) during 9-1-1 calls is critically important, but little is known about how laypersons and emergency medical dispatchers (EMDs) communicate. We sought to describe 9-1-1 calls for OHCA.
We performed a mixed-methods, retrospective analysis of 9-1-1 calls for OHCA victims in a large urban emergency medical services (EMS) system using a random sampling of cases containing the term "cardiopulmonary resuscitation" (CPR) in the EMS electronic report. A constant comparison qualitative approach with four independent reviewers continued until thematic saturation was achieved. Quantitative analysis employed computational linguistics. Callers' emotional states were rated using the emotional content and cooperation score (ECCS).
Thematic saturation was achieved after 46 calls. Three "OHCA recognition" themes emerged [ 1) disparate OHCA terms used, 2) OHCA mimics create challenges, 3) EMD questions influence recognition]. Three "CPR facilitation" themes emerged [ 1) directive language may facilitate CPR, 2) specific instructions assist CPR, 3) caller's emotions affect CPR initiation]. Callers were generally "anxious but cooperative." Callers saying "pulse" was associated with OHCA recognition.
Communication characteristics appear to influence OHCA recognition and CPR facilitation.
Dispatch protocols that acknowledge characteristics of callers' communication may improve OHCA recognition and CPR facilitation.
在拨打911电话时识别院外心脏骤停（OHCA）至关重要，但对于外行人与急救医疗调度员（EMD）之间的沟通方式却知之甚少。我们试图描述关于OHCA的911电话情况。
我们对一个大型城市急救医疗服务（EMS）系统中拨打911的OHCA受害者电话进行了混合方法的回顾性分析，采用随机抽样的方式，选取EMS电子报告中包含“心肺复苏”（CPR）一词的病例。由四名独立评审员采用持续比较定性方法，直至达到主题饱和。定量分析采用计算语言学方法。使用情感内容与合作得分（ECCS）对来电者的情绪状态进行评分。
在分析46个电话后达到主题饱和。出现了三个“OHCA识别”主题[1）使用的OHCA术语不同，2）OHCA的相似情况带来挑战，3）EMD的问题影响识别]。出现了三个“CPR促进”主题[1）指示性语言可能促进CPR，2）具体指示有助于CPR，3）来电者的情绪影响CPR的启动]。来电者总体上“焦虑但合作”。提到“脉搏”的来电者与OHCA识别相关。
沟通特征似乎会影响OHCA识别和CPR促进。
承认来电者沟通特征的调度协议可能会改善OHCA识别和CPR促进情况。
