Emergency medical dispatch services across Pan-Asian countries: a web-based survey

Shawn Chieh Loong Lee,Takahiro Hara,Chih-Hao Lin,Benjamin Sieu-Hon Leong,Faith Joan Gaerlan,Desmond Renhao Mao,Marcus Eng Hock Ong,G V Ramana Rao,Boon Yang Chia,Do Ngoc Son,Sang Do Shin,Yih Yng Ng,Jirapong Supasaovapak

doi:10.1186/s12873-019-0299-1

Abstract

BackgroundDispatch services (DS’s) form an integral part of emergency medical service (EMS) systems. The role of a dispatcher has also evolved into a crucial link in patient care delivery, particularly in dispatcher assisted cardio-pulmonary resuscitation (DACPR) during out-of-hospital cardiac arrest (OHCA). Yet, there has been a paucity of research into the emerging area of dispatch science in Asia. This paper compares the characteristics of DS’s, and state of implementation of DACPR within the Pan-Asian Resuscitation Outcomes (PAROS) network.MethodsA cross-sectional descriptive survey addressing population characteristics, DS structures and levels of service, state of DACPR implementation (including protocols and quality improvement programs) among PAROS DS’s.Results9 DS’s responded, representing a total of 23 dispatch centres from 9 countries that serve over 80 million people. Most PAROS DS’s operate a tiered dispatch response, have implemented medical oversight, and tend to be staffed by dispatchers with a predominantly medical background. Almost all PAROS DS’s have begun tracking key EMS indicators. 77.8% (n = 7) of PAROS DS’s have introduced DACPR. Of the DS’s that have rolled out DACPR, 71.4% (n = 5) provided instructions in over one language. All DS’s that implemented DACPR and provided feedback to dispatchers offered feedback on missed OHCA recognition. The majority of DS’s (83.3%; n = 5) that offered DACPR and provided feedback to dispatchers also implemented corrective feedback, while 66.7% (n = 4) offered positive feedback. Compression-only CPR was the standard instruction for PAROS DS’s. OHCA recognition sensitivity varied widely in PAROS DS’s, ranging from 32.6% (95% CI: 29.9–35.5%) to 79.2% (95% CI: 72.9–84.4%). Median time to first compression ranged from 120 s to 220 s.ConclusionsWe found notable variations in characteristics and state of DACPR implementation between PAROS DS’s. These findings will lay the groundwork for future DS and DACPR studies in the PAROS network.

Highlights

Dispatch services (DS’s) form an integral part of emergency medical service (EMS) systems
The most significant modifiable element correlated with better neurological outcomes post-of-hospital cardiac arrest (OHCA) is the time from collapse to cardiopulmonary resuscitation (CPR) and defibrillation [8, 9]
This paper aims to describe the various Dispatch Service (DS)’s within the Pan Asian Resuscitation Outcomes Study (PAROS) Clinical Research Network, their practices and interventions, and the state of dispatcher assisted cardiopulmonary resuscitation (DACPR) implementation within each DS, thereby laying a foundation for future research

Summary

Introduction

Dispatch services (DS’s) form an integral part of emergency medical service (EMS) systems. The role of a dispatcher has evolved into a crucial link in patient care delivery, in dispatcher assisted cardiopulmonary resuscitation (DACPR) during out-of-hospital cardiac arrest (OHCA). The role of a dispatcher has since This evolution has occurred amidst a rapidly aging population in some countries and increased call volumes in the Asia-Pacific region, with emergency medical conditions, including OHCA, on the rise [3]. Dispatch services in Asia and their role in out-of-hospital cardiac arrest EMS systems in Asia are heterogenous, and remain at different phases of maturity and development [4]. DACPR has been shown to raise survival and bystander CPR rates, and improve quality of life post-cardiac arrest [10]

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