Description of call handling in emergency medical dispatch centres in Scandinavia: recognition of out-of-hospital cardiac arrests and dispatcher-assisted CPR

• Published in: Scandinavian journal of trauma, resuscitation and emergency medicine resuscitation and emergency medicine, 2021-06, Vol.29 (1), p.88-88, Article 88
• Main Authors: Hardeland, Camilla, Claesson, Andreas, Blom, Marieke T, Blomberg, Stig Nikolaj Fasmer, Folke, Fredrik, Hollenberg, Jacob, Kramer-Johansen, Jo, Lippert, Freddy, Nord, Anette, Nygaard, Anne Mette, Olasveengen, Theresa Mariero, Ringh, Mattias, Svensson, Leif, Maller, Thea Palsgaard
• Format: Article
• Language: English
• Subjects: Cardiac arrest; Cardiopulmonary resuscitation; Care and treatment; CPR; CPR (First aid); Data collection; Data dictionaries; Dispatcher; Emergency medical care; Emergency medical dispatch; Emergency medical dispatch Centre; Emergency medical services; Emergency services dispatchers; Fires; Medicin och hälsovetenskap; Original Research; Paramedics; Statistics
• ISSN: 1757-7241; 1757-7241
• DOI: 10.1186/s13049-021-00903-4

Background The European resuscitation council have highlighted emergency medical dispatch centres as an important key player for early recognition of Out-of-Hospital Cardiac Arrest (OHCA) and in providing dispatcher assisted cardiopulmonary resuscitation (CPR) before arrival of emergency medical services. Early recognition is associated with increased bystander CPR and improved survival rates. The aim of this study is to describe OHCA call handling in emergency medical dispatch centres in Copenhagen (Denmark), Stockholm (Sweden) and Oslo (Norway) with focus on sensitivity of recognition of OHCA, provision of dispatcher-assisted CPR and time intervals when CPR is initiated during the emergency call (NO-CPR.sub.prior), and to describe OHCA call handling when CPR is initiated prior to the emergency call (CPR.sub.prior). Methods Baseline data of consecutive OHCA eligible for inclusion starting January 1st 2016 were collected from respective cardiac arrest registries. A template based on the Cardiac Arrest Registry to Enhance Survival definition catalogue was used to extract data from respective cardiac arrest registries and from corresponding audio files from emergency medical dispatch centres. Cases were divided in two groups: NO-CPR.sub.prior and CPR.sub.prior and data collection continued until 200 cases were collected in the NO-CPR.sub.prior-group. Results NO-CPR.sub.prior OHCA was recognised in 71% of the calls in Copenhagen, 83% in Stockholm, and 96% in Oslo. Abnormal breathing was addressed in 34, 7 and 98% of cases and CPR instructions were started in 50, 60, and 80%, respectively. Median time (mm:ss) to first chest compression was 02:35 (Copenhagen), 03:50 (Stockholm) and 02:58 (Oslo). Assessment of CPR quality was performed in 80, 74, and 74% of the cases. CPR.sub.prior comprised 71 cases in Copenhagen, 9 in Stockholm, and 38 in Oslo. Dispatchers still started CPR instructions in 41, 22, and 40% of the calls, respectively and provided quality assessment in 71, 100, and 80% in these respective instances. Conclusions We observed variations in OHCA recognition in 71-96% and dispatcher assisted-CPR were provided in 50-80% in NO-CPR.sub.prior calls. In cases where CPR was initiated prior to emergency calls, dispatchers were less likely to start CPR instructions but provided quality assessments during instructions. Keywords: Emergency medical dispatch, Cardiac arrest, Cardiopulmonary resuscitation, Cpr, Emergency medical dispatch Centre, Dispatcher, Out-of