Seizure-like presentation in OHCA creates barriers to dispatch recognition of cardiac arrest

RESUSCITATION

卷:156

Article

Schwarzkoph, Madison¹  Yin, Lihua²  Hergert, Lindsey²  Drucker, Christopher²  Counts, Catherine R.¹  Eisenberg, Mickey^1,2 

[1] Univ Washington, Sch Med, Seattle, WA 98195 USA

[2] Publ Hlth Seattle & King Cty, Div Emergency Med Serv, Seattle, WA USA

关键词: OHCA;    Seizure;    Cardiac arrest;    Dispatcher;    Telephone-CPR;    TCPR;   

DOI  :  10.1016/j.resuscitation.2020.06.036

来源: Elsevier

【 摘 要 】

Purpose: Early recognition of out-of-hospital cardiac arrest (OHCA) by 9-1-1 dispatchers is a critical first step along the resuscitation pathway. Barriers to recognition may lead to adverse outcomes among patients. This study aims to determine the impact of seizure-like activity among OHCA patients during 9-1-1 calls. Methods: We evaluated a retrospective cohort study of all adult, non-traumatic OHCAs that occurred prior to emergency medical services (EMS) arrival on scene in a major metropolitan area from 2014-2018. Dispatch recordings were reviewed to determine if seizure-like activity was reported by the caller using key descriptor phrases such as seizing, shaking, or convulsing. We compared patient demographics, arrest factors, and hospital outcomes using a regional OHCA quality improvement database. Results: Among 3502 OHCAs meeting our inclusion criteria, 149 (4.3%) contained seizure-like activity. When compared to patients without seizure-like activity (3353; 95.7%), patients presenting with seizure-like activity were younger (54 vs. 66 years old; p < 0.05), had a witnessed arrest (88% vs 45%; p < 0.05), presented with an initial shockable rhythm (52% vs. 24%; p < 0.05), and survived to hospital discharge (44% vs. 16%; p < 0.05). The seizurelike activity group also had a longer median time to dispatcher identification of the cardiac arrest [130 s (72,193) vs 62 s (43,102); p < 0.05]. Conclusions: Reported seizure-like activity among patients in cardiac arrest poses a barrier to recognition of cardiac arrests by dispatchers leading to delays in resuscitation instructions.

【 授权许可】

Free