The lay descriptors of out-of-hospital cardiac arrest in the Western Cape province, South Africa

Abstract

Introduction Out-of-Hospital Cardiac Arrest (OHCA) is a time-sensitive emergency requiring prompt identification and emergency care to reduce morbidity and mortality. The first step in managing OHCA is rapid identification by the emergency dispatch centre. Identification of these patients remains challenging in South Africa due to multiple languages and widely differing levels of education. This study aimed to identify the key descriptors (words and phrases) of OHCA used by callers in the Western Cape when contacting the provincial Emergency Medical Services' emergency call centre. Methodology Computer-aided dispatch data with a corresponding “ patient unresponsive ” incident type were drawn for a 12-month period (January–December 2018). Corresponding patient care records were extracted to verify OHCA. The original voice recordings between the caller and emergency call taker at the time of the emergency were extracted and transcribed verbatim. Transcriptions were subjected to inductive, qualitative content analysis to the manifest level. Descriptors of OHCA in isiXhosa, English and Afrikaans calls were coded, categorised, and quantified. Results A total of 729 confirmed OHCA cases were identified, of which 38 (5.2%) Afrikaans, 24 (3.3%) isiXhosa and a random sample of 50 (6.8%) English calls were transcribed. Following content analysis, five distinct categories were identified. The most prevalent categories were descriptors related to ill health (medical history and suspected diagnosis; 35.5%), level of consciousness (unresponsive; 18.6%) and cardiac activity (pulselessness and suspected death; 17.2%). Conclusion The vast majority of callers within the Western Cape province of South Africa use consistent descriptors across languages when requesting an ambulance for OHCA. Future studies should focus on the development and validation of OHCA recognition algorithms, based on these findings.

The Feasibility of Using Machine Learning to Classify Calls to South African Emergency Dispatch Centres According to Prehospital Diagnosis, by Utilising Caller Descriptions of the Incident

“…The transcriptions were originally collected in various South African languages, namely: English, Afrikaans, Zulu and Sesotho. These anonymised transcripts were obtained from previous studies on the telephonic descriptors of myocardial infarction [ 3 ], sepsis [ 7 ] and out-of-hospital cardiac arrest [ 12 ]. The telephonic conversations were transcribed and subsequently verified as either a sepsis, cardiac arrest or myocardial infarction diagnosis.…”

“…The features selected were based on previous works [ 3 , 7 , 12 ], where keywords used to describe sepsis, cardiac arrest, and acute myocardial infarction patients were identified from calls to EMS centres in South Africa. The papers quantified the frequency of keywords and from this, the ranking of descriptor categories could be realised per diagnosis.…”

Out-of-hospital cardiac arrests in the city of Cape Town, South Africa: a retrospective, descriptive analysis of prehospital patient records

“…Resuscitation and defibrillation are on the scope of practice of all cadres of prehospital providers. 27 Training for prehospital providers range from a 6-week (BLS) certificate course, to 4-year degree programme (ALS). Emergency call-takers are often nonmedically trained and perform their duties without a script or clear protocols on OHCA-recognition and telephonic cardiopulmonary resuscitation (CPR) guidance.…”

Effectiveness of school-based CPR training among adolescents to enhance knowledge and skills in CPR: A systematic review

“…These studies prove that OHCA remains the leading healthcare concern worldwide, influencing the morbidity and mortality rates of the population across the world. About 90% of patients who are victims of OHCA die before reaching the hospital; this can be attributed to poor knowledge of cardiopulmonary resuscitation (CPR) (Van Rensburg et al 2021 ). According to the Utstein definition, cardiac arrest is a sudden cessation of cardiac mechanical function as evidenced by the absence of detectable pulse, absent or gasping breath and loss of consciousness (Sandroni et al 2007 ).…”