Abstract 19180: Targeted Simulation and Education to Improve Cardiac Arrest Recognition and Telephone Cpr in an Emergency Medical Dispatch Centre
Introduction: Patient outcome after out of hospital cardiac arrest (OHCA) is dependent on emergency medical dispatchers ability to recognize OHCA and provide effective telephone-assisted CPR instructions to bystanders. The American Heart Association recommends continuous quality monitoring to ensure implementation of educational interventions in emergency medical dispatch centres.
Objective: Improve dispatcher recognition of OHCA and time to first telephone assisted chest compression.
Method: Weak aspects of cardiac arrest calls in our dispatch centre were identified, and targeted interventions to improve recognition of agonal respiration and cardiac arrest and to shorten time to first chest compression were implemented. Specifically; 1) Video-based lectures focusing on agonal respiration and continuous coaching 2) Simulation training 3) Structured dispatcher feedback 4) Electronic telephone-assisted CPR training program. Dispatch logs, ambulance records and audio files of confirmed OHCA’s were analyzed before and after the intervention. Recognition of cardiac arrest was reported as (1) recognized, (2) not recognized and (3) delayed recognition (defined as failure to initially clarify consciousness or abnormal breathing before moving on to further questioning).
Results: 289 and 221calls were included before and after intervention, respectively. Recognition of cardiac arrest improved from 74% to 89% (p<0.001), and delayed recognition was reduced from 14% to 5% (p=0.001). Agonal respiration continues to challenge dispatchers, but misinterpretation of abnormal breathing decreased from 25% to 8% (p<0.001) of calls. Median time to first chest compression was reduced by 30 seconds (204 vs. 174 seconds, respectively, p=0,039)
Conclusion: Targeted simulation and education significantly increased recognition of OHCA and reduced time to first chest compression. Continuous focus and targeted dispatcher training are important to ensure quality of care for OHCA patients.
Author Disclosures: C. Hardeland: None. L. Soilammi: None. C. Skåre: None. J. Kramer-Johansen: None. T. Birkenes: Employment; Modest; Employee of Laerdal Medical AS. H. Myklebust: Employment; Modest; Employee of Laerdal Medical AS. A.E. Hansen: None. T.M. Olasveengen: None.
- © 2015 by American Heart Association, Inc.