Title

A mixed methods analysis of caller-emergency medical dispatcher communication during 9-1-1 calls for out-of-hospital cardiac arrest

Authors

Christopher T. Richards, Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Emergency Medicine, Northwestern Feinberg School of Medicine, Chicago, IL, USA; Chicago EMS System, Chicago, IL, USA. Electronic address: christopher.richards@uc.edu.
Danielle M. McCarthy, Department of Emergency Medicine, Northwestern Feinberg School of Medicine, Chicago, IL, USA. Electronic address: d-mccarthy2@northwestern.edu.
Eddie Markul, Advocate Aurora HealthFollow
Doreen R. Rottman, Chicago Fire Department, City of Chicago, Chicago, IL, USA. Electronic address: doreen.rottman@cityofchicago.org.
Patricia Lindeman, Department of Emergency Medicine, Northwestern Feinberg School of Medicine, Chicago, IL, USA; Chicago EMS System, Chicago, IL, USA. Electronic address: plindema@nm.org.
Shyam Prabhakaran, Department of Neurology, The University of Chicago Biological Sciences, Chicago, IL, USA. Electronic address: shyam1@neurology.bsd.uchicago.edu.
Diego Klabjan, Department of Industrial Engineering and Management Sciences, Northwestern University McCormick School of Engineering, Evanston, IL, USA. Electronic address: d-klabjan@northwestern.edu.
Jane L. Holl, Department of Neurology, The University of Chicago Biological Sciences, Chicago, IL, USA. Electronic address: jholl@neurology.bsd.uchicago.edu.
Kenzie A. Cameron, Division of General Internal Medicine & Geriatrics, Northwestern Feinberg School of Medicine, Chicago, IL, USA. Electronic address: k-cameron@northwestern.edu.

Affiliations

Advocate Illinois Masonic Medical Center

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.

Document Type

Article

PubMed ID

35304072


 

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