Assessment of dispatch-assisted cardiopulmonary resuscitation performance during out-of- hospital cardiac arrest in a Tuscan emergency operation center: a retrospective study
Pubblicato 2024-06-01
Parole chiave
- Emergency,
- Nurses,
- Cardiopulmonary Resuscitation,
- Pre-Arrival Instructions,
- Outcome
Copyright (c) 2024 Giulia Ballini, Andrea Mezzetti, Stefano Bambi, Simona Casini, Yari Longobucco, Camilla Elena Magi, Laura Rasero
TQuesto lavoro è fornito con la licenza Creative Commons Attribuzione 4.0 Internazionale.
Abstract
Background: Time is the most crucial prognostic factor in out-of-hospital cardiac arrest (OHCA) owing to its clinical features. Dispatcher-assisted CPR (DA-CPR) by dispatch centers to a bystander calling for an ambulance, enabling even an inexperienced bystander to start CPR in 50% of cases and reducing the free therapy interval from chest compression to less than three minutes.
Objectives: to assess the dispatch-assisted cardiopulmonary resuscitation performance during out-of-hospital cardiac arrest. Methods: a retrospective study was conducted at the Firenze-Prato Emergency Operation Centre to analyse data collected from all dispatch audio recordings of OHCA events that occurred between 1 January 2019 and 31 December 2020. Emergency calls lasting less than 60 s were excluded from the analysis, as this duration does not provide dispatchers with adequate time to accurately identify OHCA and provide pre-arrival instructions to the bystander.
Results: A total of 1,267 OHCAs cases were included in this study, with 832 (65.7%) occurring in 2019 and 435 (34.3%) in 2020. Emergency nurses offered pre-arrival instructions in 272 cases (21.5%), with 160 cases in 2019 (19.2%) and 112 cases (25.7%) in 2020 (c2=7.19, p=0.007). These instructions were accepted by the caller in 9% (n=75) and 14% (n=61) of the cases, respectively (c2=7.48, p=0.006). OHCA events that could not be identified by telephone (therefore, DA-CPR was not possible) were 365 cases (43.9%) in 2019 and 175 cases (40.2%) in 2020 (c2=1.55, p=0.213).
Conclusions: The adoption of a standardised protocol for delivering pre-arrival instructions, along with training programs focusing on OHCA and interview techniques, is strongly recommended based on the findings of our study. This was reinforced by the analysis of nighttime calls during which DA-CPR was not provided, including cases without clear justification.
Riferimenti bibliografici
- Jerkman M, Lundgren P, Omerovic E, Stromsoe GR, Hollenberg J, Nivedahl P, et al. Association between type of bystander cardiopulmonary resuscitation and survival in out-of hospital cardiac arrest: a machine learning study. Resusc Plus. 2022; 10:100245.
- Dainty KN, Colquitt B, Hunt EA, Jefkins T, Leary M, Ornato IP, et al. Understanding the importance of the lay responder experience in out-of-hospital cardiac arrest: a scientific statement from the American Heart Association. Circulation. 2022; 145:852-e867.
- Guerrero A, Blewer AL, Joiner AP, Leong BSH, Shahidah N, Pek PP, et al. Evaluation of telephone-assisted cardiopulmonary resuscitation recommendations for out-of-hospital cardiac arrest. Resuscitation. 2022; 178:87-95.
- Dowker SR, Smith G, O’Leary M, Missel AL, Trumpower B, Hunt N, et al. Assessment of telecommunicator cardiopulmonary resuscitation performance during out-of-hospital cardiac arrest using a standardized tool for audio review. Resuscitation. 2022; 178:102-108.
- Byrsell F, Claesson A, Jonsson M, Ringh M, Svensson L, Nordberg P, et al. Swedish dispatchers’ compliance with the American Heart Association performance goals for dispatch-assisted cardiopulmonary resuscitation and its association with survival in out-of-hospital cardiac arrest: a retrospective study. Resusc Plus. 2021; 9:100190.
- Di Marco S, Tucci R, Tonelli G, Frione G, Semeraro F, Ristagno G, Scapigliati A. Preparedness for telephone dispatch-assisted cardiopulmonary resuscitation in Italy. A National survey. Resuscitation. 2020; 149:87-88.
- Crabb DB, Elmelige YO, Gubson ZC, Ralston DC, Harrell C, Cohen SA, et al. Unrecognized cardiac arrests: a one year review of audio from emergency medical dispatch calls. Am J Emerg Med. 2022 ;54:127-130.
- Wingen S, Rott N, Schittko N, Hackstein A, Kreimeier U, Bartholme B, Bottiger BW. State of implementation of telephone cardiopulmonary resuscitation by rescue coordinator centers in Germany. Dtsch Arztebl Int. 2022; 119:55-56.
- Dami F, Heymann E, Pasquier M, Fuchs V, Carron PN, Hugli O. Time to identifiy cardiac arrest and provide dispatch assisted cardio-pulmonary resuscitation in a criteria-based dispatch system. Resuscitation. 2015; 97:27-33.
- Glober NK, Supples M, Faris G, Arkins T, Christopher S, Fulks T et al. Out-of-hospital cardiac arrest volumes and characteristics during the COVID-19 pandemic. Am J Emerg Med. 2021; 48:191- 197.
- Dameff C, Vadeboncoeur T, Tully J, Panczyk M, Dunham A, Murphy R et al. A standardized template for measuring and reporting telephone pre-arrival cardiopulmonary instructions. Resuscitation. 2014; 85:869-873.
- Ferron R, Agarwal G, Cooper R, Munlkey D. The effect of Covid-19 on emergency medical service call volumes and patient acuity: a cross sectional study in Niagara, Ontario. 2021; 21:39.