Analysis of the Emergency Medical Service Call Centre Actions in Patients with Cardiac Arrest

  • Radojka Joksic-Mazinjanin University of Novi Sad, Faculty of Medicine Novi Sad, Department of emergency medicine; Institute for Emergency Medical Service, Novi Sad; Novi Sad,
  • Aleksandar Djuricin University of Novi Sad, Faculty of Medicine Novi Sad, Department of emergency medicine; Institute for Emergency Medical Service, Novi Sad; Novi Sad,
  • Milena Joksic Zelic Health Centre ''Bečej'', Emergency Medical Services, Bečej,
  • Predrag Saponja Institute for Emergency Medical Service Novi Sad, Novi Sad
  • Sinisa Saravolac Institute for Emergency Medical Service Novi Sad, Novi Sad
  • Zoran Gojkovic University of Novi Sad, Faculty of Medicine Novi Sad, Department of surgery; Clinical Centre of Vojvodina, Orthopedic Clinic; Novi Sad
  • Velibor Vasovic University of Novi Sad, Faculty of Medicine Novi Sad, Department of pharmacology, toxicology and clinical pharmacology, Novi Sad.
  • Momir Mikov University of Novi Sad, Faculty of Medicine Novi Sad, Department of pharmacology, toxicology and clinical pharmacology, Novi Sad.
Keywords: Emergency medical service, Dispatcher, Out-of-hospital cardiac arrest, cardiopulmonary resuscitation, Telephone CPR

Abstract


Background/Aim: Cardiac arrest (CA) is a leading cause of mortality in the last forty years worldwide. Immediately initiated cardiopulmonary resuscitation (CPR) improves chances for survival. Aim of this study was to determine the efficiency of the Emergency medical service (EMS) dispatch centre in the absence of the uniform emergency medical dispatch assessment protocols in the management of cardiac arrest.

Methods: The retrospective and observational study was conducted in Institute for Emergency Medical Service Novi Sad (IEMS Novi Sad) Serbia during a one-year follow-up. The study included patients with out-of-hospital cardiac arrests who underwent CPR.

Results: EMS teams of the IEMS Novi Sad had 198 CPRs in the follow-up period. In 142 (71.72 %) calls, the EMS dispatcher got information that the patient was uncon- scious. The reported reaction time I by the dispatchers for the unconscious patients was 1.37 ± 1.27 minutes, actual duration of the conversation between the dispatcher and a caller – was longer: 138.21 ± 103.02 seconds (p < 0.001). The average conversation time with a caller was 61.37 ± 31.13 seconds. In 6 (4.22 %) cases, the EMS team was dispatched to a patient before the phone call was terminated. At the moment of arrival, all patients were unconscious, 194 (94.37 %) were pulseless, while the remaining 8 (5.63 %) experienced cardiac arrest during the examination. The cardiac arrest was witnessed by a layman in 120 (84.51 %) cases and CPR was initiated by bystanders, before the arrival of the EMS team, only in 13 (10.83 %) patients. Twen- ty-seven (19.01 %) patients arrived in a hospital with vital signs.

Conclusion: The absence of the uniform EMS dispatch assessment protocols for the triage of incoming calls and phone assisted CPR for lay rescuers decreases the survival rate of patients with cardiac arrest.

References

Myerberg RJ, Castellanos A. Cardiovascular collapse, cardiac arrest and sudden cardiac death. In: Fauci AS, Braun- wald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al, editors. Harrison's principles of internal medicine. 17th ed. New York: McGraw-Hill; 2008. p. 1707-13.

Bang A, Biber B, Isaksson L, Lindqvist J, Herlitz J. Evaluation of dispatcher-assisted cardiopulmonary resuscitation. Eur J Emerg Med 1999;6(3):175-83.

Engdahl J, Bang A, Lindqvist J, Herlitz J. Factors affecting short- and long-term prognosis among 1069 patients with out-of-hospital cardiac arrest and pulseless electrical activity. Resuscitation 2001;51(1):17-25.

Waalewijn RA, Nijpels MA, Tijssen JG, Koster RW. Prevention of deterioration of ventricular fibrillation by basic life support during out-of-hospital cardiac arrest. Resuscitation 2002;54(1):31-6.

Clawson JJ, Dernocoeur KB. Principles of emergency medical dispatch. 3rd ed. Salt Lake City: Priority press; 2006.

Javno komunalno preduzeće Informatika [homepage on the internet]. Novi Sad: Broj stanovnika po naseljima; c2010 [cited: 2011-Aug-8] Available from: http://host- ing02.nsinfo.co.rs/ds0501p. Serbian.

Saxon LA. Sudden cardiac death: epidemiology and tem- poral trends. Rev Cardiovasc Med 2005;6(Suppl 2):S12- 20.

Sans S, Kesteloot H, Kromhout D. The burden of cardiovascular diseases mortality in Europe. Task Force of the European Society of Cardiology on Cardiovascular Mortality and Morbidity Statistics in Europe. Eur Heart J 1997;18(8):1231-48.

American Heart Association. Heart disease and stroke statistics-2005 update. Dallas, TX: American Heart Asso- ciation; 2004.

Rudner R, Jalowiecki P, Karpel E, Dziurdzik P, Alberski B, Kawecki P. Survival after out-of-hospital cardiac arrests in Katowice (Poland): outcome report according to the “Utstein style”. Resuscitation 2004;61(3):315-25.

Rea TD, Eisenberg MS, Culley LL, Becker L. Dispatcher-assisted cardiopulmonary resuscitation and survival in cardiac arrest. Circulation 2001;104(21):2513-6.

Ghose R, Lyon RM, Clegg GR, Gray AJ. Bystander CPR in south east Scotland increases over 16 years. Resuscitation 2010;81(11):1488-91.

Stiell I, Nichol G, Wells G, De Maio V, Nesbitt L, Blackburn J, et al. Health-related quality of life is better for cardiac arrest survivors who received citizen CPR. Circulation 2003;108(16):1939-44.

Nurmi J, Pettilä V, Biber B, Kuisma M, Komulainen R, Cas- trén M. Effect of protocol compliance to cardiac arrest identification by emergency medical dispatchers. Resuscitation 2006;70(3):463-9.

Pravilnik o pokazateljima kvaliteta zdravstvene zaštite. Broj 110-00-132/2010-02 (2010). [Cited: 2021-May-11]. Available at: https://www.rfzo.rs/download/pravilnici/ mz/pravilnik_kvalitet.pdf. Serbian.

Castrén M, Karlsten R, Lippert F, Christensen EF, Bovim E, Kvam AM, et al. Recommended guidelines for reporting on emergency medical dispatch when conducting research in emergency medicine: The Utstein style. Resuscitation 2008;79(2):193-7.

Bradley SM, Fahrenbruch CE, Meischke H, Allen J, Bloomingdale M, Rea TD. Bystander CPR in out-of-hospital cardiac arrest: the role of limited English proficiency. Resuscitation 2011;82(6):680-4.

Swor RA, Jackson RE, Compton S, Domeier R, Zalenski R, Honeycutt L, et al. Cardiac arrest in private locations: different strategies are needed to improve outcome. Resus- citation 2003;58(2):171-6.

Agarwal DA, Hess EP, Atkinson EJ, White RD. Ventricular fibrillation in Rochester, Minnesota: experience over 18 years. Resuscitation 2009;80(11):1253-8.

Lateef F, Anantharaman V. Bystander cardiopulmonary resuscitation in prehospital cardiac arrest patients in Singapore. Prehosp Emerg Care 2001;5(4):387-90.

Vukmir RB. Witnessed arrest, but not delayed bystander cardiopulmonary resuscitation improves prehospital cardiac arrest survival. Emerg Med J 2004;21(3):370-3.

Soar J , Nolan JP , Böttiger BW , Perkins GD , Lott C, Carli P, et al. European Resuscitation Council Guidelines for Resuscitation 2015: Section 3. Adult advanced life support. Resuscitation 2015;95:100-47.

Australian Resuscitation Council, New Zealand Resuscitation Council. ANZCOR Guideline 11.8 –Targeted Tem- perature Management (TTM) after Cardiac Arrest. 2016. [Cited: 2021-May-11]. Available at: https://www.nzrc.org.nz/assets/Guidelines/Adult-ALS/ANZCOR-Guideline-11.8-TTM-Jan16.pdf.

Published
2021/09/30
Section
Professional article