Opinion of specialists of emergency medical services on the practice of distance counseling on first aid: results of the interregional survey

Abstract

Introduction. Wide implementation of distance counseling of incident witnesses on first aid (DCFA) over the telephone by dispatchers of emergency medical services (EMS) can significantly increase the rate of provision of first aid (FA) by the bystanders and contribute to reduction of mortality from the life-threatening conditions. The purpose of this study was to investigate personal experience and opinions of the specialists of EMS of the Russian Federation regarding the practice of DCFA, that is important for planning and determining priority areas for the development of a unified domestic program on DCFA.Methods. In September–October 2022, an anonymous interregional survey of the EMS specialists was conducted. EMS dispatchers constituted the target group of the survey. Participation of specialists without experience of dispatching was also allowed. The survey was carried out online using a pre-tested questionnaire that included 17 questions to assess, inter alia, personal experience of DCFA, self-confidence of the specialists when giving instructions on FA over the telephone, opinion on the importance of DCFA, level of the specialists’ knowledge on FA, experience of prior training on the methods of DCFA, as well as to identify factors that prevent or hinder real practice of DCFA. To analyze the results, nonparametric statistics was used.Results. The final sample consisted of 965 EMS specialists from 58 constituent entities of the Russian Federation, of which 77.4% (n=747) were feldshers and nurses for receiving and transmitting EMS calls. 73.3% (n=707) of the respondents reported that they had experience of DCFA. The average number of cases of DCFA in the past year reported by one specialist was 97 (median=10). 87.6% (n=619) of respondents with experience of DCFA have highly rated the importance of this practice for saving human health and life. However, only 47.8% (n=338) of the specialists with experience of DCFA reported that they felt themselves completely confident when giving the instructions to bystanders. Despite the fact that the level of confidence was characterized by a positive correlation with the specialists’ assessment of their knowledge on FA (p<0.001) , only 46.4% (n=328) of the respondents with experience of DCFA have rated their knowledge as very good, and 15.7% (n=111) have ever learned the principles of DCFA. From the perspective of the respondents with experience of DCFA, main barriers to this practice include unreadiness of bystanders to follow instructions on FA, fears of dispatchers regarding possible egal liability, a lack of dispatchers and/or their overburden with receiving and transmitting calls, and a lack of clear algorithms/protocols for instructing witnesses.Conclusion. EMS dispatchers generally highly rate the importance of DCFA, but feel themselves uncertain when counseling the bystanders, and have a lack of knowledge on FA. The vast majority of the specialists have never been trained in the methods of DCFA. Priority measures aimed at implementation a unified domestic practice of DCFA include the development of a universal program for training EMS specialists on the principles and skills of DCFA, creation and testing of standardized dispatch algorithms/protocols on DCFA for various health disorders, organization of effective legal regulation for the practice of DCFA, and solution of the problem of shortage of EMS specialists who operate as dispatchers.