Delays in recognition of the need for telephone-assisted CPR due to caller descriptions of chief complaint

Abstract

BackgroundThe objective of this study was to test if caller descriptions of chief complaint delays emergency medical dispatchers’ (EMDs) recognition of the need for telephone-assisted CPR (T-CPR). MethodsWe conducted an analysis of N = 433 cardiac arrest calls from six large call centers in the United States. Calls were abstracted for initial chief complaint description: caller reports (1) correct medical condition (CMC); (2) incorrect medical condition (IMC), or (3) signs/symptoms only (SS), as well the time interval between call pickup and recognition of the need for T-CPR. In addition, we abstracted if EMDs asked questions related to the caller’s chief complaint (rather than, or before), asking about patients’ consciousness and breathing status. ResultsThe majority of cardiac arrest calls (60%) were reported as SS. Median time to recognition of the need for T-CPR was 64 s for SS chief complaints, 47 s for CMC chief complaints, and 100 s for IMC chief complaints. EMDs pursued chief complaint descriptions for 9% of the calls with SS chief complaints, 41% of the calls with IMC chief complaints, and 19% of the calls with CMC chief complaints. Median time to recognition of the need for CPR for calls in which the chief complaint description was pursued was 166 s compared to 62 s for calls in which the chief complaint description was not pursued. ConclusionCaller chief complaint description affects the time to recognition of the need for T-CPR. Clinical trial registration: http://www.clinicaltrials.gov Trial # NCT01972087.