Emergency medical service treated out-of-hospital cardiac arrest: Identification of weak links in the chain-of-survival through an epidemiological study

Sanson, Gianfranco; Verduno, Jessica; Zambon, Marco; Trevi, Roberto; Caggegi, Giuseppe Davide; Bartolomeo, Stefano Di; Antonaglia, Vittorio

doi:10.1177/1474515115573365

Cited by 18 publications

(23 citation statements)

References 44 publications

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“…Six studies relied exclusively on dispatch codes. [ 14 , 15 , 19 , 22 , 23 , 26 ] Three studies defined the outcome by specific wordings from the emergency call recordings. [ 24 , 27 , 28 ] Two studies used a combination of dispatch codes and emergency calls.…”

Section: Resultsmentioning

confidence: 99%

“…However, few studies have reported the recognition of OHCA and results have been of great variation. [ 14 , 15 ] The reason for this may be variety in competences across EMS systems or unequal registration of OHCA recognition. The importance of recognition of OHCA during the emergency call, has been emphasised in the European Resuscitation Council 2015 guidelines, however, no framework for reporting recognition has been implemented.…”

Section: Introductionmentioning

confidence: 99%

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Recognition of out-of-hospital cardiac arrest during emergency calls — a systematic review of observational studies

Viereck

Møller

Rothman

et al. 2017

Scand J Trauma Resusc Emerg Med

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BackgroundThe medical dispatcher plays an essential role as part of the first link in the Chain of Survival, by recognising the out-of-hospital cardiac arrest (OHCA) during the emergency call, dispatching the appropriate first responder or emergency medical services response, performing dispatcher assisted cardiopulmonary resuscitation, and referring to the nearest automated external defibrillator. The objective of this systematic review was to evaluate and compare studies reporting recognition of OHCA patients during emergency calls.MethodsThis systematic review was reported in compliance with the PRISMA guidelines. We systematically searched MEDLINE, Embase and the Cochrane Library on 4 November 2015. Observational studies, reporting the proportion of clinically confirmed OHCAs that was recognised during the emergency call, were included. Two authors independently screened abstracts and full-text articles for inclusion. Data were extracted and the risk of bias within studies was assessed using the QUADAS-2 tool for quality assessment of diagnostic accuracy studies.ResultsA total of 3,180 abstracts were screened for eligibility and 53 publications were assessed in full-text. We identified 16 studies including 6,955 patients that fulfilled the criteria for inclusion in the systematic review. The studies reported recognition of OHCA with a median sensitivity of 73.9% (range: 14.1–96.9%). The selection of study population and the definition of “recognised OHCA” (threshold for positive test) varied greatly between the studies, resulting in high risk of bias. Heterogeneity in the studies precluded meta-analysis.ConclusionAmong the 16 included studies, we found a median sensitivity for OHCA recognition of 73.9% (range: 14.1–96.9%). However, great heterogeneity between study populations and in the definition of “recognised OHCA”, lead to insufficient comparability of results. Uniform and transparent reporting is required to ensure comparability and development towards best practice.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Recognition of out-of-hospital cardiac arrest during emergency calls — a systematic review of observational studies

Viereck

Møller

Rothman

et al. 2017

Scand J Trauma Resusc Emerg Med

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“…77 The proportion of OHCA recognition during alarm calls ranges from 14 % and 83 %. [78][79][80][81][82] The median rate of recognition across dispatch system have been found to be 73 % in a systematic review. 83 Agonal breathing is one of the main barriers for recognition during an alarm call.…”

Section: Early Recognition and Call For Helpmentioning

confidence: 99%

Survival in Out-of-Hospital Cardiac Arrest After Standard Cardiopulmonary Resuscitation or Chest Compressions Only Before Arrival of Emergency Medical Services

et al. 2019

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“…High-quality CPR can improve the survival after an OHCA, 8 17 but it has been demonstrated that the quality of hands-only CPR decreases after 1 min. 18 Since the mean time to intervention of EMS on a cardiac arrest scenario in Europe is about 8 min, 19 it is easy to understand that it is very difficult to perform a high-quality CPR until the arrival of EMS with the hands-only technique. It has also been shown that a 10 s pause in the hands-only CPR protocol can increase its quality, 20 but there is limited evidence to support any CPR protocols for lay rescuers who are unwilling to give rescue breaths, except to perform chest compressions continuously until EMS arrival.…”

Section: Introductionmentioning

confidence: 99%

Protocol of a Multicenter International Randomized Controlled Manikin Study on Different Protocols of Cardiopulmonary Resuscitation for laypeople (MANI-CPR)

et al. 2018

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IntroductionOut-of-hospital cardiac arrest is one of the leading causes of death in industrialised countries. Survival depends on prompt identification of cardiac arrest and on the quality and timing of cardiopulmonary resuscitation (CPR) and defibrillation. For laypeople, there has been a growing interest on hands-only CPR, meaning continuous chest compression without interruption to perform ventilations. It has been demonstrated that intentional interruptions in hands-only CPR can increase its quality. The aim of this randomised trial is to compare three CPR protocols performed with different intentional interruptions with hands-only CPR.Methods and analysisThis is a prospective randomised trial performed in eight training centres. Laypeople who passed a basic life support course will be randomised to one of the four CPR protocols in an 8 min simulated cardiac arrest scenario on a manikin: (1) 30 compressions and 2 s pause; (2) 50 compressions and 5 s pause; (3) 100 compressions and 10 s pause; (4) hands-only. The calculated sample size is 552 people. The primary outcome is the percentage of chest compression performed with correct depth evaluated by a computerised feedback system (Laerdal QCPR).Ethics and dissemination. Due to the nature of the study, we obtained a waiver from the Ethics Committee (IRCCS Policlinico San Matteo, Pavia, Italy). All participants will sign an informed consent form before randomisation. The results of this study will be published in peer-reviewed journal. The data collected will also be made available in a public data repository.Trial registration numberNCT02632500.

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Emergency medical service treated out-of-hospital cardiac arrest: Identification of weak links in the chain-of-survival through an epidemiological study

Abstract: OHCA identification by dispatch nurses and reduction of response time were the factors most susceptible to improvement.

Cited by 18 publications

References 44 publications

Recognition of out-of-hospital cardiac arrest during emergency calls — a systematic review of observational studies

Recognition of out-of-hospital cardiac arrest during emergency calls — a systematic review of observational studies

Survival in Out-of-Hospital Cardiac Arrest After Standard Cardiopulmonary Resuscitation or Chest Compressions Only Before Arrival of Emergency Medical Services

Protocol of a Multicenter International Randomized Controlled Manikin Study on Different Protocols of Cardiopulmonary Resuscitation for laypeople (MANI-CPR)

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