Teaching recognition of agonal breathing improves accuracy of diagnosing cardiac arrest

Perkins, Gavin D.; Walker, Gemma; Christensen, Katie; Hulme, Jonathan; Monsieurs, Koenraad G.

doi:10.1016/j.resuscitation.2006.01.015

Cited by 48 publications

(24 citation statements)

References 15 publications

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“…40 Several strategies for teaching students how to differentiate agonal gasps from normal breathing have been evaluated. In 1 LOE D5 study, 44 teaching recognition of agonal gasps using a video clip improved the accuracy of lay rescuers in recognizing cardiac arrest. Another study (LOE D5 45 ) demonstrated that detection of true cardiac arrest cases improved after introduction of the question "Is he breathing regularly?"…”

Section: Breathing Assessmentmentioning

confidence: 99%

Part 5: Adult Basic Life Support

Sayre¹,

Koster²,

Botha³

et al. 2010

Circulation

Self Cite

152

136

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Section: Breathing Assessmentmentioning

confidence: 99%

Part 5: Adult Basic Life Support

Sayre¹,

Koster²,

Botha³

et al. 2010

Circulation

Self Cite

152

136

View full text Add to dashboard Cite

“…40,58,60 When first-year medical students received explicit teaching about agonal breathing, or gasping, as part of their training in basic life support, their accuracy in diagnosing cardiac arrest improved compared with a control group (90% versus 78%, Pϭ0.03) and increased the likelihood of CPR being initiated (sensitivity 90% versus 78%, Pϭ0.02). 61 These data collectively demonstrate the importance of emphasizing "absent or abnormal breathing (ie, only gasping)" as criteria for initiating CPR for an adult victim by introducing the concept of gasping (agonal breathing) and reinforcing that gasping should not be mistaken for normal breathing.…”

Section: Recognition Of the Emergencymentioning

confidence: 87%

Importance and Implementation of Training in Cardiopulmonary Resuscitation and Automated External Defibrillation in Schools

Cave¹,

Aufderheide²,

et al. 2011

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“…20,21 Training in the recognition of agonal respirations has been demonstrated to improve the detection of cardiac arrest. 20,[22][23][24] Not only is it imperative that dispatchers recognize cardiac arrest and provide CPR instructions, but it is important that they do so in a timely manner. We found that dispatchers were able to recognize cardiac arrest in a median time of 75 seconds.…”

Section: Timeliness Of Dispatcher-assisted Cpr 1527mentioning

confidence: 99%

Dispatcher-Assisted Cardiopulmonary Resuscitation

2013

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Background-Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR), in which 9-1-1 dispatchers provide CPR instructions over the telephone, has been shown to nearly double the rate of bystander CPR. We sought to identify factors that hampered the identification of cardiac arrest by 9-1-1 dispatchers and prevented or delayed the provision of dispatcher-assisted CPR chest compressions. Methods and Results-We reviewed dispatch recordings for 476 out-of-hospital cardiac arrests occurring between January 1, 2011, and December 31, 2011. We found that the dispatcher correctly identified cardiac arrest in 80% of reviewed cases and 92% of cases in which they were able to assess patient consciousness and breathing. The median time to recognition of the arrest was 75 seconds. Chest compressions following dispatcher-assisted CPR instructions occurred in 62% of cases when the dispatcher had the opportunity to asses for consciousness and breathing and bystander CPR was not already started. The median time to first dispatcher-assisted CPR chest compression was 176 seconds. Conclusions-Dispatchers are able to accurately diagnose cardiac arrest over the telephone, but recognition is likely not possible in all circumstances. In some cases, recognition of cardiac arrest may be improved through training in the detection of agonal respirations. Delays in the delivery of dispatcher-assisted CPR chest compressions are common and are attributable to a mixture of dispatcher behavior and factors beyond the control of the dispatcher. Performance standards for the successful and quick recognition of cardiac arrest and delivery of first chest compressions should be adopted as metrics against which emergency medical services systems can measure their performance. Lewis et alTimeliness of Dispatcher-Assisted CPR 1523 CPR program in 1982. 11 Dispatchers undergo 32 hours of emergency medical training, with 6 hours dedicated to the recognition of cardiac arrest and delivery of CPR instructions over the telephone. Dispatchers receive 8 hours of continuing education each year and undergo regular performance evaluations to ensure that quality assurance standards are met. For the purposes of this study, we use the term dispatcher to refer to the person responsible for questioning and giving instructions to the 9-1-1 caller, although this term may not be used in all emergency response systems. In the 2 communications centers participating in this study, the dispatcher handles only 1 call at a time and stays on the line until the call is terminated.Dispatchers are trained to approach every call with a high index of suspicion for cardiac arrest and to assertively provide CPR instructions in cases of suspected arrest. After the incident address is confirmed, protocol dictates that dispatchers ask every caller 2 questions: "Is the patient conscious?" and "Is the patient breathing normally?" If the caller answers no to both questions, then the patient is presumed to be in cardiac arrest and CPR instructions are provided. The protocol allows dispatc...

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Teaching recognition of agonal breathing improves accuracy of diagnosing cardiac arrest

Cited by 48 publications

References 15 publications

Part 5: Adult Basic Life Support

Part 5: Adult Basic Life Support

Importance and Implementation of Training in Cardiopulmonary Resuscitation and Automated External Defibrillation in Schools

Dispatcher-Assisted Cardiopulmonary Resuscitation

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