‘ She’s sort of breathing ’: What linguistic factors determine call-taker recognition of agonal breathing in emergency calls for cardiac arrest?

Riou, Marine; Ball, Stephen; Williams, Teresa A.; Whiteside, Austin; Cameron, Peter; Fatovich, Daniel M; Perkins, Gavin D.; Smith, Karen; Bray, Janet; Inoue, Madoka; O’Halloran, Kay; Bailey, Paul; Brink, Deon; Finn, Judith

doi:10.1016/j.resuscitation.2017.11.058

Cited by 58 publications

(38 citation statements)

References 29 publications

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“…Recent research has explored the impact of call-takers’ linguistic choices on the efficiency of ambulance dispatch in high-acuity cases, including cardiac arrests, 17 and in the detection of agonal breathing. 18 Earlier work has long recognised the communication challenges posed by the pressure of these ‘high-acuity’ and ‘high-stakes’ situations, 19 and on-going research confirms the importance of a more detailed understanding of the dynamics between caller and call-taker to improve dispatch efficiency in these circumstances (eg, refs 17 20 ). However, little work has been undertaken to explore emergency call interactions in lower-acuity situations, such as for ‘primary care sensitive’ problems.…”

Section: Introductionmentioning

confidence: 94%

‘Primary care sensitive’ situations that result in an ambulance attendance: a conversation analytic study of UK emergency ‘999’ call recordings

et al. 2018

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ObjectivesTo explore common features of conversations occurring in a sample of emergency calls that result in an ambulance dispatch for a ‘primary care sensitive’ situation, and better understand the challenges of triaging this cohort.DesignA qualitative study, applying conversation analytic methods to routinely recorded telephone calls made through the ‘999’ system for an emergency ambulance. Cases were identified by a primary care clinician, observing front-line UK ambulance service shifts. A sample of 48 ‘999’ recordings were analysed, corresponding to situations potentially amenable to primary care management.ResultsThe analysis focuses on four recurring ways that speakers use talk in these calls. Progress can be impeded when call-taker’s questions appear to require callers to have access to knowledge that is not available to them. Accordingly, callers often provide personal accounts of observed events, which may be troublesome for call-takers to ‘code’ and triage. Certain question formats—notably ‘alternative question’ formats—appear particularly problematic. Callers deploy specific lexical, grammatical and prosodic resources to legitimise the contact as ‘urgent’, and ensure that their perception of risk is conveyed. Difficulties encountered in the triage exchange may be evidence of misalignment between organisational and caller perceptions of the ‘purpose’ of the questions.ConclusionsPrevious work has focused on exploring the presentation and triage of life-threatening medical emergencies. Meaningful insights into the challenges of EMS triage can also be gained by exploring calls for ‘primary care sensitive’ situations. The highly scripted triage process requires precise, ‘codeable’ responses to questions, which can create challenges when the exact urgency of the problem is unclear to both caller and call-taker. Calling on behalf of someone else may compound this complexity. The aetiology of some common interactional challenges may offer a useful frame for future comparison between calls for ‘primary care sensitive’ situations and life-threatening emergencies.

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Section: Introductionmentioning

confidence: 94%

‘Primary care sensitive’ situations that result in an ambulance attendance: a conversation analytic study of UK emergency ‘999’ call recordings

et al. 2018

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“…Prompt action by bystanders can help to 'buy time' until more definitive treatment is available by the ambulance paramedics, and bystander CPR in this period more than doubles the chance of survival [36,37], with differences in the rates, interventions, and survival in different regions [38]. The training of takers of emergency ambulance calls also has the potential to improve bystander contributions to survival [39].…”

Section: Importance Of Delays In Acute Coronary Syndromementioning

confidence: 99%

Challenges in Managing Acute Cardiovascular Diseases and Follow Up Care in Rural Areas: A Narrative Review

Thompson

Nedkoff

Katzenellenbogen

et al. 2019

IJERPH

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This narrative review explores relevant literature that is related to the challenges in implementing evidence-based management for clinicians in rural and remote areas, while primarily focussing on management of acute coronary syndrome (ACS) and follow up care. A targeted literature search around rural/urban differences in the management of ACS, cardiovascular disease, and cardiac rehabilitation identified multiple issues that are related to access, including the ability to pay, transport and geographic distances, delays in patients seeking care, access to diagnostic testing, and timely treatment in an appropriate facility. Workforce shortages or lack of ready access to relevant expertise, cultural differences, and complexity that arises from comorbidities and from geographical isolation amplified diagnostic challenges. Given the urgency in management of ACS, rural clinicians must act quickly to achieve optimal patient outcomes. New technologies and quality improvement approaches enable better access to rapid diagnosis, as well as specialist input and care. Achieving an uptake of cardiac rehabilitation in rural and remote settings poses challenges that may reduce with the use of alternative models to centre-based rehabilitation and use of modern technologies. Expediting improvement in cardiovascular outcomes and reducing rural disparities requires system changes and that clinicians embrace attention to prevention, emergency management, and follow up care in rural contexts.

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“…Bezüglich der DA-CPR sei hier beispielhaft auf die Frage „Atmet die Person normal?“ eingegangen, um zu zeigen, wie Schulung auf die Leistung der Notrufexperten Einfluss nehmen kann. In einer englischsprachigen Studie von Riou [ 15 ] wurden Anrufe mit rückgemeldeten OHCA durch die Einsatzkräfte vor Ort analysiert. Der Fokus lag auf sprachlichen Faktoren der Beantwortung der Frage „Atmet der Patient normal?“ durch den Anrufer.…”

Section: Telefonreanimationunclassified

“…Begründungen für die „Ja, aber“-Antworten findet Riou im Übrigen im sprachlichen Kontext wissenschaftlicher Untersuchungen. „Research on spontaneous conversation has identified a social preference for confirming answers to questions“ ([ 15 ]; deutsche Übersetzung: „Studien zu spontanen Gesprächen zeigen eine soziale Tendenz, auf Fragen bestätigend zu antworten“). Auf den Notrufdialog bezogen tendieren Ersthelfer mit Zweifel, „ob der Patient atmet oder nicht“, dazu, bejahend beschreibend zu antworten, beispielsweise mit „Ja, aber er/sie keucht/schnarcht“.…”

Section: Telefonreanimationunclassified

Strukturierte bzw. standardisierte Notrufabfrage

Mayr

2020

Notfall Rettungsmed

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Hintergrund Die zunehmende Einführung von standardisierten Notrufabfragesystemen im deutschsprachigen Raum folgt den Empfehlungen des European Resuscitation Council (ERC) und German Resuscitation Council (GRC), wonach die Notfallmeldung anhand vorgegebener Protokolle abgefragt werden soll. Obwohl in Bezug auf das Erkennen spezieller Krankheitsbilder durchaus Verbesserungsbedarf hinsichtlich Sensitivität und Spezifität bestehen kann, stellen standardisierte Produkte das Mittel der Wahl zur Notrufabfrage dar, da sie unabhängig von Nutzer, Uhrzeit und Tagesform eine gleichbleibende Anrufbearbeitung ermöglichen können. Dies erhöht die Patientensicherheit ebenso wie die Rechtssicherheit der Leitstellenmitarbeiter und der Unternehmensführung. Fragestellung Leisten Systeme der standardisierten Notrufabfrage tatsächlich das, was sie vorgeben zu leisten? Methode Recherche aktueller Literatur und Studien Ergebnis Grundsätzlich leisten die Produkte das, was sie versprechen zu leisten. Die Qualität hängt maßgeblich von der Compliance der Notrufexperten und den definierten Standards zur Anwendung ab. Schlussfolgerung Optimierungsbedarf besteht vor allem in der Erstellung von Standards zur Anwendung von Abfragesystemen und in der Ausbildung der Mitarbeiter.

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‘ She’s sort of breathing ’: What linguistic factors determine call-taker recognition of agonal breathing in emergency calls for cardiac arrest?

Abstract: There is potential for improved recognition of agonal breathing if call-takers are trained to be alert to any qualification following a confirmation that the patient is breathing.

Cited by 58 publications

References 29 publications

‘Primary care sensitive’ situations that result in an ambulance attendance: a conversation analytic study of UK emergency ‘999’ call recordings

‘Primary care sensitive’ situations that result in an ambulance attendance: a conversation analytic study of UK emergency ‘999’ call recordings

Challenges in Managing Acute Cardiovascular Diseases and Follow Up Care in Rural Areas: A Narrative Review

Strukturierte bzw. standardisierte Notrufabfrage

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