Stephanie Crause, Helen Slabber, Elzarie Theron, Willem Stassen

Telephonic descriptions of out-of-hospital cardiac arrest by laypersons calling the dispatch centre of a private emergency medical service in South Africa

Introduction

Telephonic descriptions of out-of-hospital cardiac arrest by laypersons calling the dispatch centre of a private emergency medical service in south africa. Examines keywords laypersons use to describe out-of-hospital cardiac arrest (OHCA) to private EMS dispatch in South Africa, aiming to enhance call-taker recognition and telephone-guided CPR.

Abstract

Background: The incidence of out-of-hospital cardiac arrest (OHCA) is expected to increase in South Africa. In order to encourage bystander cardiopulmonary resuscitation (CPR), international guidelines recommend call-taker recognition of the arrest and the initiation of telephone-guided CPR. One of the only ways that a call-taker can identify OHCA is through the description of the incident offered by the caller. The aim of this study was to identify the keywords and phrases that are used by callers to describe patients who are experiencing OHCA during calls made to a South African private Emergency Medical Service (EMS). Methods: A qualitative exploratory design was used and employed inductive dominant content analysis to identify the keywords and phrases that are used by callers to describe patients who are experiencing OHCA during calls made to a South African private EMS. The initial sampling frame was all cases of the “Cardiac Arrest” incident type recorded between 1 January 2019 and 31 December 2019. Results: A total of 28 call recordings were analysed. Keywords and phrases were organised into five categories: 1) Cardiac activity; 2) Level of consciousness; 3) Breathing descriptors; 4) Ill health; and 5) Clinical features. Conclusion: Callers into a private emergency dispatch centre used consistent descriptors of OHCA, which were similar to those found in previous South African studies. Future research should focus on determining the accuracy of these descriptors to differentiate between OHCA and other conditions, and integrate them into OHCA recognition algorithms, call-taker training and telephone-guided CPR protocols.

Review

This paper addresses a critical aspect of emergency medical services: the initial recognition of out-of-hospital cardiac arrest (OHCA) by dispatch call-takers. Given the anticipated increase in OHCA incidence in South Africa and the importance of timely bystander cardiopulmonary resuscitation (CPR), the ability of call-takers to accurately identify OHCA from layperson descriptions is paramount for initiating telephone-guided CPR. The study’s objective to identify specific keywords and phrases used by callers reporting OHCA to a private South African EMS dispatch centre is highly relevant, filling a vital gap in understanding initial communication dynamics during life-threatening emergencies. Employing a qualitative exploratory design with inductive dominant content analysis, the researchers meticulously examined 28 call recordings related to OHCA incidents from 2019. The methodology allowed for the identification and categorization of callers' descriptors into five distinct themes: cardiac activity, level of consciousness, breathing descriptors, ill health, and other clinical features. A key finding was the consistency of these OHCA descriptors used by callers, notably aligning with observations from prior South African studies. This consistency provides a valuable foundation for developing targeted recognition tools. The study makes a valuable contribution by empirically detailing how laypersons communicate OHCA symptoms, information crucial for refining dispatch protocols. While the sample size is modest for generalizability, the findings offer practical insights for enhancing call-taker training and improving the efficacy of telephone-guided CPR initiatives. The authors rightly recommend future research to focus on validating the accuracy of these descriptors in differentiating OHCA from other conditions and to integrate them directly into OHCA recognition algorithms. This forward-looking perspective underscores the study's potential to significantly improve emergency response outcomes in South Africa, serving as a solid stepping stone for further research and practical implementation.

Full Text

Comments

You need to be logged in to post a comment.