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160. 2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Author

Wyckoff, Myra H., primary, Singletary, Eunice M., additional, Soar, Jasmeet, additional, Olasveengen, Theresa M., additional, Greif, Robert, additional, Liley, Helen G., additional, Zideman, David, additional, Bhanji, Farhan, additional, Andersen, Lars W., additional, Avis, Suzanne R., additional, Aziz, Khalid, additional, Bendall, Jason C., additional, Berry, David C., additional, Borra, Vere, additional, Böttiger, Bernd W., additional, Bradley, Richard, additional, Bray, Janet E., additional, Breckwoldt, Jan, additional, Carlson, Jestin N., additional, Cassan, Pascal, additional, Castrén, Maaret, additional, Chang, Wei-Tien, additional, Charlton, Nathan P., additional, Cheng, Adam, additional, Chung, Sung Phil, additional, Considine, Julie, additional, Costa-Nobre, Daniela T., additional, Couper, Keith, additional, Dainty, Katie N., additional, Davis, Peter G., additional, de Almeida, Maria Fernanda, additional, de Caen, Allan R., additional, de Paiva, Edison F., additional, Deakin, Charles D., additional, Djärv, Therese, additional, Douma, Matthew J., additional, Drennan, Ian R., additional, Duff, Jonathan P., additional, Eastwood, Kathryn J., additional, El-Naggar, Walid, additional, Epstein, Jonathan L., additional, Escalante, Raffo, additional, Fabres, Jorge G., additional, Fawke, Joe, additional, Finn, Judith C., additional, Foglia, Elizabeth E., additional, Folke, Fredrik, additional, Freeman, Karoline, additional, Gilfoyle, Elaine, additional, Goolsby, Craig A., additional, Grove, Amy, additional, Guinsburg, Ruth, additional, Hatanaka, Tetsuo, additional, Hazinski, Mary Fran, additional, Heriot, George S., additional, Hirsch, Karen G., additional, Holmberg, Mathias J., additional, Hosono, Shigeharu, additional, Hsieh, Ming-Ju, additional, Hung, Kevin K.C., additional, Hsu, Cindy H., additional, Ikeyama, Takanari, additional, Isayama, Tetsuya, additional, Kapadia, Vishal S., additional, Kawakami, Mandira Daripa, additional, Kim, Han-Suk, additional, Kloeck, David A., additional, Kudenchuk, Peter J., additional, Lagina, Anthony T., additional, Lauridsen, Kasper G., additional, Lavonas, Eric J., additional, Lockey, Andrew S., additional, Malta Hansen, Carolina, additional, Markenson, David, additional, Matsuyama, Tasuku, additional, McKinlay, Christopher J.D., additional, Mehrabian, Amin, additional, Merchant, Raina M., additional, Meyran, Daniel, additional, Morley, Peter T., additional, Morrison, Laurie J., additional, Nation, Kevin J., additional, Nemeth, Michael, additional, Neumar, Robert W., additional, Nicholson, Tonia, additional, Niermeyer, Susan, additional, Nikolaou, Nikolaos, additional, Nishiyama, Chika, additional, O’Neil, Brian J., additional, Orkin, Aaron M., additional, Osemeke, Osokogu, additional, Parr, Michael J., additional, Patocka, Catherine, additional, Pellegrino, Jeffrey L., additional, Perkins, Gavin D., additional, Perlman, Jeffrey M., additional, Rabi, Yacov, additional, Reynolds, Joshua C., additional, Ristagno, Giuseppe, additional, Roehr, Charles C., additional, Sakamoto, Tetsuya, additional, Sandroni, Claudio, additional, Sawyer, Taylor, additional, Schmölzer, Georg M., additional, Schnaubelt, Sebastian, additional, Semeraro, Federico, additional, Skrifvars, Markus B., additional, Smith, Christopher M., additional, Smyth, Michael A., additional, Soll, Roger F., additional, Sugiura, Takahiro, additional, Taylor-Phillips, Sian, additional, Trevisanuto, Daniele, additional, Vaillancourt, Christian, additional, Wang, Tzong-Luen, additional, Weiner, Gary M., additional, Welsford, Michelle, additional, Wigginton, Jane, additional, Wyllie, Jonathan P., additional, Yeung, Joyce, additional, Nolan, Jerry P., additional, Berg, Katherine M., additional, Abelairas-Gómez, Cristian, additional, Barcala-Furelos, Roberto, additional, Beerman, Stephen B., additional, Bierens, Joost, additional, Cacciola, Sofia, additional, Cellini, Jacqueline, additional, Claesson, Andreas, additional, Court, Rachael, additional, D'Arrigo, Sonia, additional, De Brier, Niels, additional, Dunne, Cody L., additional, Elsenga, Hylmar E., additional, Johnson, Samantha, additional, Kleven, Gunn, additional, Maconochie, Ian, additional, Mecrow, Tom, additional, Morgan, Patrick, additional, Otto, Quentin, additional, Palmieri, Tina L., additional, Parnia, Sam, additional, Pawar, Rahul, additional, Pereira, João, additional, Rudd, Sarah, additional, Scapigliati, Andrea, additional, Schmidt, Andrew, additional, Seesink, Jeroen, additional, Sempsrott, Justin R., additional, Szpilman, David, additional, Warner, David S., additional, Webber, Jonathon B., additional, and West, Rebecca L., additional

Published
2021
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163. Emergency care practitioners’ knowledge, preparedness and experiences of managing COVID-19 in Australia

Author

Li, Cecilia, primary, Sotomayor-Castillo, Cristina, additional, Nahidi, Shizar, additional, Kuznetsov, Sergey, additional, Considine, Julie, additional, Curtis, Kate, additional, Fry, Margaret, additional, Morgan, Dominic, additional, Walker, Tony, additional, Burgess, Alaine, additional, Carver, Hamish, additional, Doyle, Brian, additional, Tran, Viet, additional, Varshney, Kavita, additional, and Shaban, Ramon Z., additional

Published
2021
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164. Impact of a care bundle for patients with blunt chest injury (ChIP): A multicentre controlled implementation evaluation

Author

Curtis, Kate, primary, Kourouche, Sarah, additional, Asha, Stephen, additional, Considine, Julie, additional, Fry, Margaret, additional, Middleton, Sandy, additional, Mitchell, Rebecca, additional, Munroe, Belinda, additional, Shaban, Ramon Z., additional, D’Amato, Alfa, additional, Skinner, Clare, additional, Wiseman, Glen, additional, and Buckley, Thomas, additional

Published
2021
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167. Increasing accuracy in documentation through the application of a structured emergency nursing framework: A multisite quasi‐experimental study.

Author

Munroe, Belinda, Curtis, Kate, Fry, Margaret, Shaban, Ramon Z., Moules, Peter, Elphick, Tiana‐Lee, Ruperto, Kate, Couttie, Tracey, and Considine, Julie

Subjects
ELECTRONIC health record standards, MEDICAL quality control, RESEARCH, RURAL hospitals, HOSPITAL emergency services, RESEARCH methodology, FISHER exact test, MANN Whitney U Test, CONCEPTUAL structures, PRE-tests & post-tests, T-test (Statistics), PEARSON correlation (Statistics), CHI-squared test, COMMUNICATION, RESEARCH funding, DESCRIPTIVE statistics, MEDICAL history taking, DATA analysis software, EMERGENCY nursing, NURSING records, NURSING assessment, NURSING interventions, NURSING diagnosis
Abstract

Aims and Objectives: To determine if the use of an emergency nursing framework improves the accuracy of clinical documentation. Background: Accurate clinical documentation is a nursing professional responsibility essential for high‐quality and safe patient care. The use of the emergency nursing framework "HIRAID" (History, Identify Red flags, Assessment, Interventions, Diagnostics, reassessment and communication) improves emergency nursing care by reducing treatment delays and improving escalation of clinical deterioration. The effect of HIRAID on the accuracy of nursing documentation is unknown. Design: A quasi‐experimental pre‐post study was conducted and the report was guided by the strengthening the reporting of observational studies in epidemiology (STROBE) checklist. Methods: HIRAID was implemented in four regional/rural Australian emergency departments (ED) using a range of behaviour change strategies. The blinded electronic healthcare records of 120 patients with a presenting problem of shortness of breath, abdominal pain or fever were reviewed. Quantity measures of completeness and qualitative measures of completeness and linguistic correctness of documentation adapted from the D‐Catch tool were used to assess accuracy. Differences between pre‐post groups were analysed using Wilcoxon rank‐sum and two‐sample t‐tests for continuous variables. Pearson's Chi‐square and Fisher exact tests were used for the categorical data. Results: The number of records containing the essential assessment components of emergency care increased significantly from pre‐ to post‐implementation of HIRAID. This overall improvement was demonstrated in both paediatric and adult populations and for all presentation types. Both the quantitative and qualitative measures of documentation on patient history and physical assessment findings improved significantly. Conclusion: Use of HIRAID improves the accuracy of clinical documentation of the patient history and physical assessment in both adult and paediatric populations. Relevance to Clinical Practice: The emergency nursing framework "HIRAID" is recommended for use in clinical practice to increase the documentation accuracy performed by emergency nurses. [ABSTRACT FROM AUTHOR]

Published
2022
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182. 2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Author

Wyckoff, Myra H., Singletary, Eunice M., Soar, Jasmeet, Olasveengen, Theresa M., Greif, Robert, Liley, Helen G., Zideman, David, Bhanji, Farhan, Andersen, Lars W., Avis, Suzanne R., Aziz, Khalid, Bendall, Jason C., Berry, David C., Borra, Vere, B��ttiger, Bernd W., Bradley, Richard, Bray, Janet E., Breckwoldt, Jan, Carlson, Jestin N., Cassan, Pascal, Castr��n, Maaret, Chang, Wei-Tien, Charlton, Nathan P., Cheng, Adam, Chung, Sung Phil, Considine, Julie, Costa-Nobre, Daniela T., Couper, Keith, Dainty, Katie N., Davis, Peter G., de Almeida, Maria Fernanda, de Caen, Allan R., de Paiva, Edison F., Deakin, Charles D., Dj��rv, Therese, Douma, Matthew J., Drennan, Ian R., Duff, Jonathan P., Eastwood, Kathryn J., Epstein, Jonathan L., Escalante, Raffo, Fabres, Jorge G., Fawke, Joe, Finn, Judith C., Foglia, Elizabeth E., Folke, Fredrik, Freeman, Karoline, Gilfoyle, Elaine, Goolsby, Craig A., Grove, Amy, Guinsburg, Ruth, Hatanaka, Tetsuo, Hazinski, Mary Fran, Heriot, George S., Hirsch, Karen G., Holmberg, Mathias J., Hosono, Shigeharu, Hsieh, Ming-Ju, Hung, Kevin K.C., Hsu, Cindy H., Ikeyama, Takanari, Isayama, Tetsuya, Kapadia, Vishal S., Kawakami, Mandira, Kim, Han-Suk, Kloeck, David A., Kudenchuk, Peter J., Lagina, Anthony T., Lauridsen, Kasper G., Lavonas, Eric J., Lockey, Andrew S., Malta Hansen, Carolina, Markenson, David, Matsuyama, Tasuku, McKinlay, Christopher J.D., Mehrabian, Amin, Merchant, Raina M., Meyran, Daniel, Morley, Peter T., Morrison, Laurie J., Nation, Kevin J., Nemeth, Michael, Neumar, Robert W., Nicholson, Tonia, Niermeyer, Susan, Nikolaou, Nikolaos, Nishiyama, Chika, O���Neil, Brian J., Orkin, Aaron M., Osemeke, Osokogu, Parr, Michael J., Patocka, Catherine, Pellegrino, Jeffrey L., Perkins, Gavin D., Perlman, Jeffrey M., Rabi, Yacov, Reynolds, Joshua C., Ristagno, Giuseppe, Roehr, Charles C., Sakamoto, Tetsuya, Sandroni, Claudio, Sawyer, Taylor, Schm��lzer, Georg M., Schnaubelt, Sebastian, Semeraro, Federico, Skrifvars, Markus B., Smith, Christopher M., Smyth, Michael A., Soll, Roger F., Sugiura, Takahiro, Taylor-Phillips, Sian, Trevisanuto, Daniele, Vaillancourt, Christian, Wang, Tzong-Luen, Weiner, Gary M., Welsford, Michelle, Wigginton, Jane, Wyllie, Jonathan P., Yeung, Joyce, Nolan, Jerry P., Berg, Katherine M., Abelairas-G��mez, Cristian, Barcala-Furelos, Roberto, Beerman, Stephen B., Bierens, Joost, Cacciola, So���a, Cellini, Jacqueline, Claesson, Andreas, Court, Rachael, D'Arrigo, Sonia, De Brier, Niels, Dunne, Cody L., Elsenga, Hylmar E., Johnson, Samantha, Kleven, Gunn, Maconochie, Ian, Mecrow, Tom, Morgan, Patrick, Otto, Quentin, Palmieri, Tina L., Parnia, Sam, Pawar, Rahul, Pereira, Jo��o, Rudd, Sarah, Scapigliati, Andrea, Schmidt, Andrew, Seesink, Jeroen, Sempsrott, Justin R., Szpilman, David, Warner, David S., Webber, Jonathon B., and West, Rebecca L.

Subjects
610 Medicine & health
Published
2021
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183. Additional file 1 of Systems for recognition and response to deteriorating emergency department patients: a scoping review

Author

Considine, Julie, Fry, Margaret, Curtis, Kate, and Shaban, Ramon Z.

Subjects
humanities
Abstract

Additional file 1: Supplementary Table 1. Studies detailing systems for recognising and responding to clinical deterioration in emergency department patients. Supplementary Table 2. Systems for recognition of clinical deterioration in Emergency Department patients.

Published
2021
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184. Emergency care practitioners' knowledge, preparedness and experiences of managing COVID-19 in Australia

Author

Li, Cecilia, Sotomayor-Castillo, Cristina, Nahidi, Shizar, Kuznetsov, Sergey, Considine, Julie, Curtis, Kate, Fry, Margaret, Morgan, Dominic, Walker, Tony, Burgess, Alaine, Carver, Hamish, Doyle, Brian, Tran, Viet, Varshney, Kavita, and Shaban, Ramon Z.

Subjects
Coronavirus, Infectious Diseases, Public Health, Environmental and Occupational Health, COVID-19, Article, General Nursing
Published
2021

186. The effect of alternative methods of cardiopulmonary resuscitation — Cough CPR, percussion pacing or precordial thump — on outcomes following cardiac arrest. A systematic review

Author

Dee, Ryan, primary, Smith, Michael, additional, Rajendran, Kausala, additional, Perkins, Gavin D., additional, Smith, Christopher M., additional, Vaillancourt, Christian, additional, Avis, Suzanne, additional, Brooks, Steven, additional, Castren, Maaret, additional, Chung, Sung Phil, additional, Considine, Julie, additional, Escalante, Raffo, additional, Han, Lim Swee, additional, Hatanaka, Tetsuo, additional, Hazinski, Mary Fran, additional, Hung, Kevin, additional, Kudenchuk, Peter, additional, Morley, Peter, additional, Ng, Kee-Chong, additional, Nishiyama, Chika, additional, Semeraro, Federico, additional, and Smyth, Michael, additional

Published
2021
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190. Enhancing active patient participation in nursing handover: A mixed methods study.

Author

Street, Maryann, Dempster, Jenny, Berry, Debra, Gray, Erika, Mapes, Joanne, Liskaser, Raj, Papageorgiou, Sia, and Considine, Julie

Subjects
MEDICAL quality control, RESEARCH, PATIENT participation, RESEARCH methodology, PATIENT-centered care, INTERVIEWING, NURSE-patient relationships, DECISION making, DESCRIPTIVE statistics, CHI-squared test, HOSPITAL nursing staff, THEMATIC analysis, DATA analysis software, NURSING students, LONGITUDINAL method
Abstract

Aims and objectives: To explore: i) the frequency and nature of patient participation in nursing handover and ii) patients' and nurses' perceived strategies to enhance patient involvement in nursing handover. Background: Patient participation in nursing handover is important for patient‐centred care, shared decision‐making, patient safety and a positive healthcare experience Design: A multi‐site prospective study using a mixed methods design. Methods: Between September and December 2019, nursing handovers were observed on ten randomly selected wards, followed by semi‐structured interviews with patients (n = 33), and nurses (n = 20) from the observed handovers. Data were analysed using descriptive statistics for structured observations and thematic analysis of interviews, and triangulated to develop a greater understanding of patient participation in nursing handover. This study is reported using the Good Reporting of Mixed Methods Study guidelines. Results: The median patient age was 77 years and 47% (n = 55) patients were female. Of the 117 handovers, 76.9% (n = 90) were conducted in the patient's presence. Patients were active participants in 33.3% (n = 30) and passive participants in 46.7% (n = 42) of handovers; in 20% of handovers (n = 18), the patient had no input at all. Active participation was more likely in women (vs. men), surgical patients (vs. medical patients) and when nurses displayed engagement behaviours (eye contact, opportunity to ask questions, explanations). Three major themes were identified from the interviews: 'Being Involved', 'Layers of Influence' and 'Information Exchange'. Conclusions: The main finding was that patient participation in handover was low and strongly influenced by a complex interplay of factors including patient and nurse preferences and perceptions. Relevance to Clinical Practice: Handover is an essential tool in the provision of safe patient care. Patients were able to actively participate in nursing handover when they understood the purpose and timing of handover and had rapport with nurses. [ABSTRACT FROM AUTHOR]

Published
2022
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191. Recognizing and responding to clinical deterioration in adult patients in isolation precautions for infection control: a retrospective cohort study.

Author

Berry, Debra, Street, Maryann, Hall, Kylie, Sprogis, Stephanie K, and Considine, Julie

Abstract

Background Patient isolation is widely used as a strategy for prevention and control of infection but may have unintended consequences for patients. Early recognition and response to acute deterioration is an essential component of safe, quality patient care and has not been explored for patients in isolation. Objective The primary aims of this study were to (i) describe the timing, frequency and nature of clinical deterioration during hospital admission for patients with isolation precautions for infection control and (ii) compare the characteristics of patients who did and did not deteriorate during their initial period of isolation precautions for infection control. Methods This retrospective cohort study was conducted across three sites of a large Australian health service. The study sample were adult patients (≥18 years) admitted into isolation precautions within 24 h of admission from 1 July 2019 to 31 December 2019. Results There were 634 patients who fulfilled the study inclusion criteria. One in eight patients experienced at least one episode of clinical deterioration during their time in isolation with most episodes of deterioration occurring within the first 2 days of admission. Timely Medical Emergency Team calls occurred in almost half the episodes of deterioration; however, the same proportion (47.2%) of deterioration episodes resulted in no Medical Emergency Team activation (afferent limb failure). In the 24 h preceding each episode of clinical deterioration (n  = 180), 81.6% (n  = 147) of episodes were preceded by vital signs fulfilling pre-Medical Emergency Team criteria. Patients who deteriorated during isolation for infection control were older (median age 74.0 vs 71.0 years, P  = 0.042); more likely to live in a residential care facility (21.0% vs 7.2%, P  = 0.006); had a longer initial period of isolation (4.0 vs 2.9 days, P  =   <   000.1) and hospital length-of-stay (median 4.9 vs 3.2 days, P  =   <   0.001) and were more likely to die in hospital (12.3% vs 4.3%, P  < 0.001). Conclusion Patients in isolation precautions experienced high Medical Emergency Team afferent limb failure and most fulfilled pre-Medical Emergency Team criteria in the 24 h preceding episodes of deterioration. Timely recognition and response to clinical deterioration continue to be essential in providing safe, quality patient care regardless of the hospital-care environment. [ABSTRACT FROM AUTHOR]

Published
2022
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193. Diagnosis of out-of-hospital cardiac arrest by emergency medical dispatch: A diagnostic systematic review

Author

Drennan, Ian R., primary, Geri, Guillaume, additional, Brooks, Steve, additional, Couper, Keith, additional, Hatanaka, Tetsuo, additional, Kudenchuk, Peter, additional, Olasveengen, Theresa, additional, Pellegrino, Jeffrey, additional, Schexnayder, Stephen M., additional, Morley, Peter, additional, Mancini, Mary Beth, additional, Travers, Andrew, additional, Castren, Maaret, additional, Considine, Julie, additional, Escalante, Raffo, additional, Vaillancourt, Christian, additional, Ristagno, Giuseppe, additional, Smyth, Michael, additional, Chung, Sung Phil, additional, Perkins, Gavin, additional, Nishiyama, Chika, additional, Hung, Kevin, additional, Semeraro, Federico, additional, Avis, Suzanne, additional, Smith, Chris, additional, Aickin, Richard, additional, Atkins, Dianne, additional, Bingham, Robert, additional, Couto, Thomaz Bittencourt, additional, de Caen, Allan, additional, Guerguerian, Anne-Marie, additional, Hazinski, Mary Fran, additional, Maconochie, Ian, additional, Nadkarni, Vinay, additional, Ng, Kee-Chong, additional, Nuthall, Gabrielle, additional, Gene Ong, Yong-Kwang, additional, Reis, Amelia, additional, Shimizu, Naoki, additional, Tijssen, Janice, additional, Van de Voorde, Patrick, additional, Greif, Robert, additional, Bhanji, Farhan, additional, Finn, Judith, additional, Bigham, Blair, additional, Frengley, Robert, additional, Iwami, Taku, additional, Lockey, Andrew, additional, Ma, Matthew, additional, Bray, Janet, additional, Yeung, Joyce, additional, Duff, Jonathan, additional, Ong, Marcus, additional, Okamoto, Deems, additional, Hsieh, Ming-Ju, additional, Monsieurs, Koen, additional, and Breckwoldt, Jan, additional

Published
2021
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195. Measuring organizational context in Australian emergency departments and its impact on stroke care and patient outcomes

Author

Schadewaldt, Verena, primary, McElduff, Benjamin, additional, D'Este, Catherine, additional, McInnes, Elizabeth, additional, Dale, Simeon, additional, Fasugba, Oyebola, additional, Cadilhac, Dominique A, additional, Considine, Julie, additional, Grimshaw, Jeremy M., additional, Cheung, N Wah, additional, Levi, Chris, additional, Gerraty, Richard, additional, Fitzgerald, Mark, additional, and Middleton, Sandy, additional

Published
2021
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197. Diagnosis of out-of-hospital cardiac arrest by emergency medical dispatch: A diagnostic systematic review

Author

Drennan, Ian R., Geri, Guillaume, Brooks, Steve, Couper, Keith, Hatanaka, Tetsuo, Kudenchuk, Peter, Olasveengen, Theresa, Pellegrino, Jeffrey, Schexnayder, Stephen M., Morley, Peter, Mancini, Mary Beth, Travers, Andrew, Castren, Maaret, Considine, Julie, Escalante, Raffo, Vaillancourt, Christian, Ristagno, Giuseppe, Smyth, Michael, Chung, Sung Phil, Perkins, Gavin, Nishiyama, Chika, Hung, Kevin, Semeraro, Federico, Avis, Suzanne, Smith, Chris, Aickin, Richard, Atkins, Dianne, Bingham, Robert, Couto, Thomaz Bittencourt, de Caen, Allan, Guerguerian, Anne-Marie, Hazinski, Mary Fran, Maconochie, Ian, Nadkarni, Vinay, Ng, Kee-Chong, Nuthall, Gabrielle, Gene Ong, Yong-Kwang, Reis, Amelia, Shimizu, Naoki, Tijssen, Janice, Van de Voorde, Patrick, Greif, Robert, Bhanji, Farhan, Finn, Judith, Bigham, Blair, Frengley, Robert, Iwami, Taku, Lockey, Andrew, Ma, Matthew, Bray, Janet, Yeung, Joyce, Duff, Jonathan, Ong, Marcus, Okamoto, Deems, Hsieh, Ming-Ju, Monsieurs, Koen, Breckwoldt, Jan, International Liaison Committee on Resuscitation (ILCOR), BLS Task Force, Pediatric Task Force, EIT Task Force, and International Liaison Committee on Resuscitation (ILCOR)

Subjects
Emergency Medical Services, Diagnostic accuracy, 030204 cardiovascular system & hematology, Emergency Nursing, Out of hospital cardiac arrest, 03 medical and health sciences, 0302 clinical medicine, Emergency medical services, Or education, Medicine, Humans, business.industry, Emergency Medical Service Communication Systems, 030208 emergency & critical care medicine, Emergency Medical Dispatch, medicine.disease, Cardiopulmonary Resuscitation, Emergency Medical Dispatcher, 3. Good health, Emergency response, Emergency Medicine, Bystander cpr, Emergency medical dispatch, Medical emergency, Human medicine, Cardiology and Cardiovascular Medicine, business, RA, Resource utilization, Out-of-Hospital Cardiac Arrest, RC
Abstract

Introduction\ud Cardiac arrest is a time-sensitive condition requiring urgent intervention. Prompt and accurate recognition of cardiac arrest by emergency medical dispatchers at the time of the emergency call is a critical early step in cardiac arrest management allowing for initiation of dispatcher-assisted bystander CPR and appropriate and timely emergency response. The overall accuracy of dispatchers in recognizing cardiac arrest is not known. It is also not known if there are specific call characteristics that impact the ability to recognize cardiac arrest.\ud \ud Methods\ud We performed a systematic review to examine dispatcher recognition of cardiac arrest as well as to identify call characteristics that may affect their ability to recognize cardiac arrest at the time of emergency call. We searched electronic databases for terms related to “emergency medical dispatcher”, “cardiac arrest’, and “diagnosis,” among others, with a focus on studies that allowed for calculating diagnostic test characteristics (e.g. sensitivity and specificity). The review was consistent with Grading of Recommendations, Assessment, Development and Evaluation (GRADE) method for evidence evaluation.\ud \ud Results\ud We screened 2520 article titles, resulting in 47 studies included in this review. There was significant heterogeneity between studies with a high risk of bias in 18 of the 47 which precluded performing meta-analyses. The reported sensitivities for cardiac arrest recognition ranged from 0.46 to 0.98 whereas specificities ranged from 0.32 to 1.00. There were no obvious differences in diagnostic accuracy between different dispatching criteria/algorithms or with the level of education of dispatchers.\ud \ud Conclusion\ud The sensitivity and specificity of cardiac arrest recognition at the time of emergency call varied across dispatch centres and did not appear to differ by dispatch algorithm/criteria used or education of the dispatcher, although comparisons were hampered by heterogeneity across studies. Future efforts should focus on ways to improve sensitivity of cardiac arrest recognition to optimize patient care and ensure appropriate and timely resource utilization

Published
2020

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