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Cardiac arrest diagnostic accuracy of 9-1-1 dispatchers: a prospective multi-center study

Christian Vaillancourt1, Manya Charette2, Ann Kasaboski2

  • 1Department of Emergency Medicine, University of Ottawa, Ottawa, ON, Canada; Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada; Department of Epidemiology and Community Medicine, University of Ottawa, ON, Canada.

Resuscitation
|March 14, 2015
PubMed

Insights

9-1-1 dispatchers demonstrated fair sensitivity and modest specificity in identifying out-of-hospital cardiac arrest (OOHCA). Inappropriately, few patients not experiencing OOHCA received chest compressions, supporting current dispatch-assisted CPR protocols.

Area of Science:

  • Emergency Medical Services
  • Public Health
  • Cardiology

Background:

  • Accurate identification of out-of-hospital cardiac arrest (OOHCA) by 9-1-1 dispatchers is crucial for timely intervention.
  • Assessing dispatcher accuracy in recognizing OOHCA and the frequency of CPR instructions for non-cardiac arrest patients is important for protocol evaluation.

Purpose of the Study:

  • To evaluate the accuracy of 9-1-1 dispatchers in identifying out-of-hospital cardiac arrest (OOHCA) via telephone.
  • To determine the rate of CPR instruction and chest compression delivery in patients not experiencing cardiac arrest.

Main Methods:

  • A multi-center, prospective cohort study involving adult OOHCA patients.
  • Review of 2260 9-1-1 call recordings for unconscious patients where cardiac arrest was considered.
  • Standardized data collection by trained dispatchers not healthcare professionals.

Main Results:

  • Dispatchers achieved 65.9% sensitivity and 32.3% specificity in recognizing OOHCA.
  • Among 724 non-OOHCA cases, dispatchers incorrectly suspected cardiac arrest in 490 instances.
  • Only 2.4% of all patients inappropriately received chest compressions.

Conclusions:

  • 9-1-1 dispatchers exhibit fair sensitivity and modest specificity for OOHCA recognition.
  • The low rate of CPR in non-arrest patients supports the continued use of dispatch-assisted CPR instructions.
Abstract

Keywords:
9-1-1 dispatchersCPR instructionsCardiac arrestChest compressionsDispatch-assisted CPR

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