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Dispatcher Performance and Prehospital Outcomes in Telephone-Assisted Airway Management following Foreign Body
Aida Jahangiri1, Sina Valiee2, Naser Kamyari3
1Student Research Committee, Research Institute for Health Development, School of Nursing and Midwifery, Kurdistan University of Medical Sciences, sanandaj, Iran.
Introduction:
Prehospital care plays a crucial role in early recognition and timely management of foreign body airway obstruction (FBAO). This study aimed to identify factors associated with dispatcher performance and prehospital outcomes in the telephone-assisted management of FBAO.
Methods:
This cross-sectional study was conducted through a review of recorded emergency telephone calls related to FBAO. Data were collected from the prehospital emergency medical services center over a one-year period, from March 20, 2024 to March 20, 2025. Demographic characteristics of dispatcher were obtained through self-reported questionnaires. Recorded calls were assessed using validated 13-item researcher-developed checklist based on the standardized telephone assistance algorithm for FBAO, categorized across three age groups (score range 0-1). Patient demographic characteristics, clinical characteristics, and prehospital outcomes, including recovery without dispatch of an operational team and dispatch of an operational team, were extracted from electronic medical records. Data were entered and analyzed using SPSS version 16. A p-value < 0.05 was considered statistically significant.
Results:
A total of 262 telephone assistance FBAO cases were included in the final analysis, of which 45.8% involved infants. The overall mean dispatcher performance score was 0.87 ± 0.10. Multivariable logistic regression analysis demonstrated that patient's age (adjusted odds ratio (AOR) = 1.60, 95% confidence interval (CI): 1.13-2.26, p = 0.008) and dispatcher's clinical experience (AOR = 1.44, 95% CI: 1.05-1.98, p = 0.023) were significant positive predictors of better performance of dispatcher. In contrast, contractual employment (AOR = 0.37, 95% CI: 0.21-0.68, p = 0.001), higher monthly overtime hours (AOR = 0.33, 95% CI: 0.16-0.68, p = 0.002), and non-participation in stress management workshops (AOR = 0.40, 95% CI: 0.23-0.68, p = 0.001) were negatively associated with dispatcher performance. Complete airway obstruction (AOR = 0.08, 95% CI: 0.03-0.17, p < 0.001), occurrence in an outdoor setting (AOR = 4.86, 95% CI: 1.60-16.40, p = 0.007), and involvement of non-edible foreign bodies (AOR = 0.16, 95% CI: 0.06-0.37, p < 0.001) were significant predictors of outcomes.
Conclusion:
The findings indicate that dispatcher performance in telephone-assisted management of FBAO was generally acceptable. Enhancing performance requires not only simulation-based training but also consideration of individual and occupational factors affecting dispatchers. Moreover, improving patient outcomes depends on dispatchers' awareness of patient-specific characteristics to ensure timely and context-appropriate interventions.
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