Dispatcher-assisted cardiopulmonary resuscitation for paediatric out-of-hospital cardiac arrest: A structured evaluation of communication issues using the SACCIA® safe communication typology

Abstract

Aim: To evaluate communication issues during dispatcher-assisted cardiopulmonary resuscitation (DACPR) for paediatric out-of-hospital cardiac arrest in a structured manner to facilitate recommendations for training improvement. Methods: A retrospective observational study evaluated DACPR communication issues using the SACCIA 1 Safe Communication typology (Sufficiency, Accuracy, Clarity, Contextualization, Interpersonal Adaptation). Telephone recordings of 31 cases were transcribed verbatim and analysed with respect to encoding, decoding and transactional communication issues. Results: Sixty SACCIA communication issues were observed in the 31 cases, averaging 1.9 issues per case. A majority of the issues were related to sufficiency (35%) and accuracy (35%) of communication between dispatcher and caller. Situation specific guideline application was observed in CPR practice, (co)counting and methods of compressions. Conclusion: This structured evaluation identified specific issues in paediatric DACPR communication. Our training recommendations focus on situation and language specific guideline application and moving beyond verbal communication by utilizing the smart phone's functions. Prospective efforts are necessary to follow-up its translation into better paediatric DACPR outcomes.

Emergency medical dispatch services across Pan-Asian countries: a web-based survey

“…Unfortunately, this increases the staffing requirement in an already resource-limited region. In light of the potential complex multilingual environments, the preference for internally-developed scripts may be due to the need for phrasing to be simple enough to translate on-the-fly [22]. Future DACPR scripts should therefore strive to utilize simple, unambiguous and easy-to-translate language to facilitate this, in the absence of DACPR scripts in the local language.…”

A scoping review to determine the barriers and facilitators to initiation and performance of bystander cardiopulmonary resuscitation during emergency calls

“…, 37. , 52. Perception of patient wishes Unable to move patient Poor/inadequate instructions Perceived appropriateness Patient difficult to access 25.…”

“… Technical language Perceived alive How directions are worded Perceived death Bystander calling from landline 55 Communication failure 37. , 52. Patient age Lack of understanding Patient sex (male) Language barrier Obvious death Caller providing inadequate information 35 Unwitnessed OHCA Relationship to patient Caller relaying instructions to other bystanders 27.…”

“…, 46. , 52. call dispatch systems could have a repertoire of prompts that call-takers can draw from to provide context to callers and encourage them to perform CPR.…”

Relief Alternatives during Resuscitation: Instructions to Teach Bystanders. A Randomized Control Trial

“…From that point on, the attempts to combine standardized communication in CPR have increased [ 4 , 5 ], with supporters [ 6 ] and critics [ 7 ] until 2019, when the International Liaison Committee on Resuscitation (ILCOR) [ 8 ] recommended that the dispatchers provide instructions to the bystanders. From that point on, many research studies provided information about the increased survival rate [ 9 , 10 ], and affirmed that the provision of dispatch cardiopulmonary resuscitation instructions, instead of no instructions at all, improved the results from cardiopulmonary arrest [ 11 ].…”