|Title:||Impact of the caller's emotional state and cooperation on out-of-hospital cardiac arrest recognition and dispatcher-assisted cardiopulmonary resuscitation||Authors:||Chien C.-Y.
MATTHEW HUEI-MING MA
|Issue Date:||2019||Journal Volume:||36||Journal Issue:||10||Start page/Pages:||595-600||Source:||Emergency Medicine Journal||Abstract:||
Objective This study determined the impact of the caller's emotional state and cooperation on out-of-hospital cardiac arrest (OHCA) recognition and dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) performance metrics. Methods This was a retrospective study using data from November 2015 to October 2016 from the emergency medical service dispatching centre in northern Taiwan. Audio recordings of callers contacting the centre regarding adult patients with non-traumatic OHCA were reviewed. The reviewers assigned an emotional content and cooperation score (ECCS) to the callers. ECCS 1-3 callers were graded as cooperative and ECCS 4-5 callers as uncooperative and highly emotional. The relation between ECCS and OHCA recognition, time to key events and DA-CPR delivery were investigated. Results Of the 367 cases, 336 (91.6%) callers were assigned ECCS 1-3 with a good inter-rater reliability (k=0.63). Dispatchers recognised OHCA in 251 (68.4%) cases. Compared with callers with ECCS 1, callers with ECCS 2 and 3 were more likely to give unambiguous responses about the patient's breathing status (adjusted OR (AOR)=2.6, 95% CI 1.1 to 6.4), leading to a significantly higher rate of OHCA recognition (AOR=2.3, 95% CI 1.1 to 5.0). Thirty-one callers were rated uncooperative (ECCS 4-5) but had shorter median times to OHCA recognition and chest compression (29 and 122 s, respectively) compared with the cooperative caller group (38 and 170 s, respectively). Nevertheless, those with ECCS 4-5 had a significantly lower DA-CPR delivery rate (54.2% vs 85.9%) due to 'caller refused' or 'overly distraught' factors. Conclusions The caller's high emotional state is not a barrier to OHCA recognition by dispatchers but may prevent delivery of DA-CPR instruction. However, DA-CPR instruction followed by first chest compression is possible despite the caller's emotional state if dispatchers are able to skilfully reassure the emotional callers. ? Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
|URI:||https://scholars.lib.ntu.edu.tw/handle/123456789/455713||DOI:||10.1136/emermed-2018-208353||SDG/Keyword:||aged; Article; audio recording; breathing; caller; child; consciousness; cooperation; cross-sectional study; emergency health service; emergency medical dispatcher; emotion; female; friend; grandchild; human; interrater reliability; male; miscellaneous named groups; nursing staff; out of hospital cardiac arrest; priority journal; resuscitation; retrospective study; spouse; Taiwan; communication barrier; cooperation; emergency medical dispatcher; first aid; middle aged; out of hospital cardiac arrest; procedures; professional-patient relationship; psychology; reproducibility; resuscitation; telephone; time factor; very elderly; Aged; Aged, 80 and over; Cardiopulmonary Resuscitation; Communication Barriers; Cooperative Behavior; Emergency Medical Dispatcher; Emergency Medical Service Communication Systems; Emotions; Female; First Aid; Humans; Male; Middle Aged; Out-of-Hospital Cardiac Arrest; Professional-Patient Relations; Reproducibility of Results; Retrospective Studies; Taiwan; Telephone; Time Factors
|Appears in Collections:||醫學院附設醫院 (臺大醫院)|
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