A mixed methods analysis of caller-emergency medical dispatcher communication during 9–1–1 calls for out-of-hospital cardiac arrest. Issue 7 (July 2022)

• Record Type: Journal Article
• Authors: Richards, Christopher T.; McCarthy, Danielle M.; Markul, Eddie; Rottman, Doreen R.; Lindeman, Patricia; Prabhakaran, Shyam; Klabjan, Diego; Holl, Jane L.; Cameron, Kenzie A.
• Is Part Of: Patient education and counseling. Volume 105:Issue 7(2022)
• Page Start: 2130
• Page End: 2136
• Publication Date: 2022-07
• Subjects: Emergency medical services -- Emergency medical dispatch -- Emergency communication -- CPR -- Cardiac arrest; AED automated external defibrillator -- CPR cardiopulmonary resuscitation -- ECCS emotional content and cooperation score -- EMD emergency medical dispatcher -- EMS emergency medical services -- OHCA out-of-hospital cardiac arrest -- VF ventricular fibrillation -- VT ventricular tachycardia; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2022.03.004
• Languages: English
• ISSNs: 0738-3991

Abstract

Abstract: Objective: Recognition of out-of-hospital cardiac arrest (OHCA) during 9–1–1 calls is critically important, but little is known about how laypersons and emergency medical dispatchers (EMDs) communicate. We sought to describe 9–1–1 calls for OHCA. Methods: We performed a mixed-methods, retrospective analysis of 9–1–1 calls for OHCA victims in a large urban emergency medical services (EMS) system using a random sampling of cases containing the term "cardiopulmonary resuscitation" (CPR) in the EMS electronic report. A constant comparison qualitative approach with four independent reviewers continued until thematic saturation was achieved. Quantitative analysis employed computational linguistics. Callers' emotional states were rated using the emotional content and cooperation score (ECCS). Results: Thematic saturation was achieved after 46 calls. Three "OHCA recognition" themes emerged [ 1) disparate OHCA terms used, 2) OHCA mimics create challenges, 3) EMD questions influence recognition]. Three "CPR facilitation" themes emerged [ 1) directive language may facilitate CPR, 2) specific instructions assist CPR, 3) caller's emotions affect CPR initiation]. Callers were generally "anxious but cooperative." Callers saying "pulse" was associated with OHCA recognition. Conclusion: Communication characteristics appear to influence OHCA recognition and CPR facilitation. Practice implications: Dispatch protocols that acknowledge characteristics of callers' communication may improve OHCA recognition and CPR facilitation. Highlights: A mixed methods approach was used to analyze 9–1–1 calls for cardiac arrest. 9–1–1 callers' communication characteristics influence cardiac arrest recognition. Emergency medical dispatchers' communication may influence if CPR is performed. Understanding communication characteristics may help improve 9–1–1 call interaction.