Enhancing the detection of out-of-hospital cardiac arrest: a study of emergency medical system in Thailand

Authors

  • Nantawan Tippayanate Field of study Paramedicine, Faculty of Medicine, Mahasarakham University, Thailand
  • Patchalee Phonkanya Command Control Center of Subdistrict Administrative Organization, Mahasarakham Province, Thailand
  • Kanokwan Nuangkantee Command Control Center of Subdistrict Administrative Organization, Mahasarakham Province, Thailand
  • Kamonchanok Nuangkantee Command Control Center of Subdistrict Administrative Organization, Mahasarakham Province, Thailand
  • Kwansiri Raksapakdee Command Control Center of Subdistrict Administrative Organization, Mahasarakham Province, Thailand
  • Watcharaporn Boonnop Command Control Center, Chao Phraya Abhaibhubejhr Hospital, Prachinburi Province, Thailand
  • Natlada Jitsuwan Command Control Center of Subdistrict Administrative Organization, Songkhla Province, Thailand

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20233076

Keywords:

Out-of-hospital cardiac arrest, Emergency medical dispatcher, OHCA recognition time, Time to start of chest compressions, Dispatch assisted CPR

Abstract

Background: Globally, survival rates for out-of-hospital cardiac arrest remain low. Implementing a dispatch-assisted cardiopulmonary resuscitation protocol in evolving emergency medical services systems has shown potential for improving OHCA detection and reducing the time to initiate chest compressions.

Methods: In this study, audio recordings of OHCA emergency calls from different regions of Thailand were analyzed from January 2021 to December 2021. The study aimed to assess OHCA detection efficiency and provide CPR recommendations, including OHCA discrimination rates, time from call initiation to OHCA identification, and time to start CPR following dispatcher guidance.

Results: There were 280 OHCA cases, with 170 (60.7%) successfully identified and excluded by dispatchers. OHCA detection took an average of 39 seconds (compared to a benchmark of 60 seconds), while the mean time from notification to chest compression initiation was 298 seconds (compared to a benchmark of 220 seconds). However, OHCA discrimination and phone-based resuscitation advice were highly sensitive (81.18%), accurate (85.72%), and specific (92.73%).

Conclusions: OHCA presents challenges, with the need for faster CPR initiation. Improving reporting processes, enhancing caller understanding, and refining dispatcher skills are crucial to enhance OHCA detection and DA-CPR, ultimately improving survival rates.

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References

Heward A, Damiani M, Hartley- Sharpe C. Does the use of the Advanced Medical Priority Dispatch System affect cardiac arrest detection? Emerg Med J. 2004;21(1):115-18.

Maier M, Luger M, Baubin M. Telephone-assisted CPR: A literature review. Emerg Med J. 2016;19: 468-72.

Shijiao Y, Yong G, Nan J, Rixing W, Yunqiang C, Zhiqian L, et al. The global survival rate among adult out-of-hospital cardiac arrest patients who received cardiopulmonary resuscitation: a systematic review and meta-analysis. BMC. 2020;24(61):1-13.

Shao F, Li CS, Liang LR, Li D, Ma SK. Outcome of out-of-hospital cardiac arrests in Beijing, China. Resuscitation. 2014;85(11):1411-7.

Yuling C, Peng YW, Jia YL, Ding G, Jiang L, Pengda H. Trend in survival after out-of-hospital cardiac arrest and its relationship with bystander cardiopulmonary resuscitation: a six-year prospective observational study in Beijing. BMC Cardiovasc Disord. 2021;21(625):1-13.

Waalwijk JF, Lokerman RD, van der Sluijs R, Fiddelers AAA, Leenen LPH, van Heijl M, et al. Priority accuracy by dispatch centers and Emergency Medical Services professionals in trauma patients: a cohort study. Eur J Trauma Emerg Surg. 2022;48(2): 1111-20.

Stinne ER, Mette AN, Katrine BB, Lise QK, Kristian K, Jonas AP, et al. Dispatcher-Assisted Cardiopulmonary Resuscitation Among ILCOR Member Countries. Emerg Med. 2020;12:67-71.

Søren V, Thea PM, Annette KE, Josefine SB, Andreas C, Jacob H, et al. Recognizing out-of-hospital cardiac arrest during emergency calls increases bystander cardiopulmonary resuscitation and survival. Resuscitation. 2017;115:141-7.

Clement D, Daniel J, Oscar T, Stephane T, Benoit F, Xavier L, et al. Improving Emergency Call Detection of Out-of-Hospital Cardiac Arrests in the Greater Paris Area: Efficiency of a Global System with a New Method of Detection. Resuscitation. 2019;146:34-2.

Fabrice D, Eric H, Mathieu P. Time to identify cardiac arrest and provide dispatch assisted CPR in a criteria based dispatch system. Resuscitation. 2015;3: 1-7.

Nishiyama C, Sato R, Baba M. Actual resuscitation action after the training of chest compression- only CPR and AED use among new university students. Resuscitation. 2019;141:63-8.

Sunisa T, Krongkan S, Rudklao S, Cherdpong P, Prinya T, Wiput L, et al. Accuracy of diagnosis of out-of-hospital cardiac arrest by emergency dispatchers. J Public Health Syst Res. 2020;14(2): 189-96.

Fredrik B, Andreas C, Mattias R. Machine learning can support dispatchers to better and faster recognize out of hospital cardiac arrest during emergency calls: A retrospective study. Resuscitation. 2021;162:218-26.

Tasuku M, Okubo M, Kiyohara K. Sex based disparities in receiving bystander cardiopulmonary resuscitation by location of cardiac arrest in Japan. Mayo Clin Proc. 2019;94(4):577-87.

Blewer AL, McGovern SK, Schmicker RH. Gender disparities among adult recipients of bystander cardiopulmonary resuscitation in the public. Circ Cardiovasc Qual Outcomes. 2018;11(8):1-9.

Matsui S, Kitamura T, Kiyohara K. Sex disparities in receipt of bystander interventions for students who experienced cardiac arrest in Japan. JAMA. 2011; 2(5):1-10.

Kim DK, Shin SD, Ro YS. Place-provider-matrix of bystander cardiopulmonary resuscitation and outcomes of out-of-hospital cardiac arrest: A nationwide observational cross-sectional analysis. Plos One. 2020;15(5):1-16.

Brinkrolf P, Metelmann B, Scharte C. Bystander-witnessed cardiac arrest is associated with reported agonal breathing and leads to less frequent bystander CPR. Resuscitation. 2018;127:114-8.

Camilla H, Olasveengen TM. Comparison of medical priority dispatch (MPD) and criteria based dispatch (CBD) relating to cardiac arrest calls. Resuscitation. 2013;85(5):612-6.

Chang I, Kwak YH, Shin SD, Ro YS, Kim DK. Characteristics of bystander cardiopulmonary resuscitation for paediatric out-of-hospital cardiac arrests: a national observational study from 2012 to 2014. Resuscitation. 2016;111:26-33.

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Published

2023-09-30

How to Cite

Tippayanate, N., Phonkanya, P., Nuangkantee, K., Nuangkantee, K., Raksapakdee, K., Boonnop, W., & Jitsuwan, N. (2023). Enhancing the detection of out-of-hospital cardiac arrest: a study of emergency medical system in Thailand. International Journal Of Community Medicine And Public Health, 10(10), 3490–3495. https://doi.org/10.18203/2394-6040.ijcmph20233076

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Section

Original Research Articles