Zaheri Fatemeh, Abdi Alireza, Rahmati Mahmoud
Emergency & Critical Care Department, Nursing & Midwifery School, Kermanshah University of Medical Science, Kermanshah, Iran.
Emergency and Critical Care Nursing Department, Nursing And Midwifery School, Kermanshah University of Medical Sciences, Kermanshah, Iran.
BMC Emerg Med. 2025 May 30;25(1):87. doi: 10.1186/s12873-025-01240-w.
Telephone Cardiopulmonary Resuscitation (T-CPR), administered by Emergency Medical Dispatchers (EMDs) to bystanders at the scene of an out-of-hospital cardiac arrest (OHCA), faces significant challenges. These challenges arise when collaboration for CPR is difficult due to the bystander's condition or when the patient's condition is not visible. Limited research exists on T-CPR, which is why our study aims to explore the experiences of Kermanshah EMDs in providing T-CPR.
This descriptive phenomenological (because there is lack of information and study about this subject in Iran and importance of a deep understanding to examine different aspect of the subject) study was conducted with 12 EMDs from a total of 20 in Kermanshah EMDs. Data were collected through in-depth, semi-structured interviews with participants selected via purposive sampling. The study was qualitative and the questionnaire was not validated. Interviews consisted of both open-ended and probing questions. This research was carried out in 2020-2021. Data were analyzed thematically using Collizi's seven-step.
Analysis of the 12 interviews conducted with dispatchers who had an average age of 28.33 years and 2.33 years of work experience resulted in the identification of 456 codes. These codes were categorized into three main themes: (1) "Perceived Nursing Care in T-CPR," which includes sub-themes such as Ethical and Emotional Management in Care, Empathetic Care, Crisis Management and Stress Control; (2) "Professional Abilities of EMDs," which includes sub-themes like Perceived Professional Skills and Satisfaction from Successful Performance; and (3) "Cultural Necessities Related to Telephone Resuscitation," with sub-themes such as Challenges of Training, Communication Barriers and the Need for Public Education and Cultural Change.
Participants reported that T-CPR is often unsuccessful due to factors such as non-collaboration from bystanders or improper execution, stemming from low education levels, cultural barriers and a general lack of public awareness about emergency procedures. Successful T-CPR requires dispatchers to skillfully communicate with anxious bystanders and correct misconceptions that CPR may worsen the patient's condition. Additionally, fluency in various accents, improving public education, and implementing effective stress management strategies are essential for improving outcomes. Addressing these issues through better education and cultural change is vital for enhancing T-CPR effectiveness.
由急救医疗调度员（EMD）在院外心脏骤停（OHCA）现场向旁观者实施的电话心肺复苏（T-CPR）面临重大挑战。当由于旁观者的状况而难以进行心肺复苏协作或患者状况不可见时，就会出现这些挑战。关于T-CPR的研究有限，这就是我们的研究旨在探索克尔曼沙赫EMD提供T-CPR的经验的原因。
本描述性现象学研究（因为伊朗缺乏关于该主题的信息和研究，且深入理解该主题的不同方面很重要）对克尔曼沙赫EMD中总共20名中的12名EMD进行。数据通过对通过目的抽样选择的参与者进行深入的半结构化访谈收集。该研究是定性的，问卷未经验证。访谈包括开放式和探究性问题。本研究于2020 - 2021年进行。使用科利齐的七步法对数据进行主题分析。
对平均年龄为28.33岁、工作经验为2.33年的调度员进行的12次访谈分析产生了456个代码。这些代码被分为三个主要主题：（1）“T-CPR中的感知护理”，包括护理中的伦理和情绪管理、共情护理、危机管理和压力控制等子主题；（2）“EMD的专业能力”，包括感知专业技能和成功表现的满意度等子主题；（3）“与电话复苏相关的文化需求”，包括培训挑战、沟通障碍以及公众教育和文化变革的必要性等子主题。
参与者报告称，由于旁观者不合作或执行不当等因素，T-CPR往往不成功，这些因素源于教育水平低、文化障碍以及公众对急救程序普遍缺乏认识。成功的T-CPR要求调度员与焦虑的旁观者巧妙沟通，并纠正关于心肺复苏可能使患者病情恶化的误解。此外，精通各种口音、改善公众教育以及实施有效的压力管理策略对于改善结果至关重要。通过更好的教育和文化变革解决这些问题对于提高T-CPR有效性至关重要。
