Recognition of out-of-hospital cardiac arrest by medical dispatchers in emergency medical dispatch centres in two countries

TY - JOUR

T1 - Recognition of out-of-hospital cardiac arrest by medical dispatchers in emergency medical dispatch centres in two countries

AU - Møller, Thea Palsgaard

AU - Andréll, Cecilia

AU - Viereck, Søren

AU - Todorova, Lizbet

AU - Friberg, Hans

AU - Lippert, Freddy K

N1 - Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

PY - 2016/12/1

Y1 - 2016/12/1

N2 - Introduction Survival after out-of-hospital cardiac arrest (OHCA) remains low. Early recognition by emergency medical dispatchers is essential for an effective chain of actions, leading to early cardiopulmonary resuscitation, use of an automated external defibrillator and rapid dispatching of the emergency medical services. Aim To analyse and compare the accuracy of OHCA recognition by medical dispatchers in two countries. Method An observational register-based study collecting data from national cardiac arrest registers in Denmark and Sweden during a six-month period in 2013. Data were analysed in two steps; registry data were merged with electronically registered emergency call data from the emergency medical dispatch centres in the two regions. Cases with missing or non-OHCA dispatch codes were analysed further by auditing emergency call recordings using a uniform data collection template. Results The sensitivity for recognition of OHCA was 40.9% (95% CI: 37.1–44.7%) in the Capital Region of Denmark and 78.4% (95% CI: 73.2–83.0%) in the Skåne Region in Sweden (p < 0.001). With additional data from the emergency call recordings, the sensitivity was 80.7% (95% CI: 77.7–84.3%) and 86.0% (95% CI: 81.3–89.8%) for the two regions (p = 0.06). The majority of the non-recognised OHCA were dispatched with the highest priority. Conclusion The accuracy of OHCA recognition was high and comparable. We identified large differences in data registration practices despite the use of similar dispatch tools. This raises a discussion of definitions and transparency in general in scientific reporting of OHCA recognition, which is essential if used as quality indicator in emergency medical services

AB - Introduction Survival after out-of-hospital cardiac arrest (OHCA) remains low. Early recognition by emergency medical dispatchers is essential for an effective chain of actions, leading to early cardiopulmonary resuscitation, use of an automated external defibrillator and rapid dispatching of the emergency medical services. Aim To analyse and compare the accuracy of OHCA recognition by medical dispatchers in two countries. Method An observational register-based study collecting data from national cardiac arrest registers in Denmark and Sweden during a six-month period in 2013. Data were analysed in two steps; registry data were merged with electronically registered emergency call data from the emergency medical dispatch centres in the two regions. Cases with missing or non-OHCA dispatch codes were analysed further by auditing emergency call recordings using a uniform data collection template. Results The sensitivity for recognition of OHCA was 40.9% (95% CI: 37.1–44.7%) in the Capital Region of Denmark and 78.4% (95% CI: 73.2–83.0%) in the Skåne Region in Sweden (p < 0.001). With additional data from the emergency call recordings, the sensitivity was 80.7% (95% CI: 77.7–84.3%) and 86.0% (95% CI: 81.3–89.8%) for the two regions (p = 0.06). The majority of the non-recognised OHCA were dispatched with the highest priority. Conclusion The accuracy of OHCA recognition was high and comparable. We identified large differences in data registration practices despite the use of similar dispatch tools. This raises a discussion of definitions and transparency in general in scientific reporting of OHCA recognition, which is essential if used as quality indicator in emergency medical services

KW - Journal Article

U2 - 10.1016/j.resuscitation.2016.09.012

DO - 10.1016/j.resuscitation.2016.09.012

M3 - Journal article

C2 - 27658652

SN - 0300-9572

VL - 109

SP - 1

EP - 8

JO - Resuscitation

JF - Resuscitation

ER -