Abstract 311: Performance of Video-assisted Cardiac Arrest Recognition Protocol for Emergency Medical Dispatch in Out-of-hospital Cardiac Arrest

Abstract

Introduction: Cardiac arrest recognition in emergency medical dispatch (EMD) is an important process for initiation of telephone CPR that could lead to bystander CPR before emergency medical service (EMS) arrival. Video-assisted protocol was developed and implemented for better recognition of cardiac arrest suspected calls that recognition was uncertain under conventional audio-call dispatch. We tested the performance of video-assisted protocol after pilot implementation in a dispatch center. Methods: All emergency medical dispatch calls received by Seoul emergency dispatch center that used video-assisted recognition protocol from Jun. 2020 to Dec. 2020 were enrolled. The primary outcome was the presence of cardiac arrest at EMS arrival evaluated by EMS providers arrived at the scene. The predictive performance measure of video-assisted protocol was calculated including sensitivity and specificity with 95% confidence interval (CI). Result: During the study period, video-assisted protocol was used in 115 emergency calls that dispatchers were uncertain during initial audio-call. In 15 cases the dispatcher additionally recognized the case as cardiac arrest under video-assistance. Of recognized cases, 14 (93.3%) cases were cardiac arrest when EMS arrived at scene. The sensitivity (95% CI) and the specificity (95% CI) of video-assistance protocol were 63.6% (40.7 - 82.8) and 98.9% (94.2 - 100) respectively. Conclusion: Use of video-assisted protocol helped recognizing additional cardiac arrest cases that could not be recognized with the audio-call in the dispatch center. Technological and operational improvement should be continuously studied for better cardiac arrest recognition using video-assisted protocol during emergency call taking.