Analysis of the emergency medical service call centre actions in patients with cardiac arrest

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 unconscious. 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. Twenty-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.

Prehospital care of injured patients in a mass casualty incidents

“…Osim jedinstvenog broja, trebao bi da postoji i jedinstveni protokol postupanja u masovnim nesrećama koji bi obuhvatao i organizaciju i postupanje u dispečerskom centru. Dispečerski centar ima važnu ulogu u zbrinjavanju svih unesrećenih, tako da proces zbrinjavanja treba da krene od njega (8). U slučaju masovne nesreće, nakon dobijanja informacije, bilo od dispečerskog centra Centra za dobaveštavanje i uzbunjivanje, bilo direkto od građana, dežurni dispečer hitne službe koja je primila poziv je dužan da proveri tačnost dobijene informacije.…”