'She's sort of breathing': What linguistic factors determine call-taker recognition of agonal breathing in emergency calls for cardiac arrest?

RESUSCITATION

卷:122

Article

Riou, Marine¹  Ball, Stephen¹  Williams, Teresa A.^1,2,3,4  Whiteside, Austin²  Cameron, Peter⁵  Fatovich, Daniel M.^1,3,4,6  Perkins, Gavin D.^7,8  Smith, Karen^3,5,9,10  Bray, Janet^1,5  Inoue, Madoka¹  O'Halloran, Kay L.¹¹  Bailey, Paul^1,2  Brink, Deon^1,2  Finn, Judith^1,2,3,5 

[1] Curtin Univ, Sch Nursing Midwifery & Paramed, PRECRU, Bentley, WA, Australia

[2] St John Ambulance WA, Belmont, MA 6104, Australia

[3] Univ Western Australia, Emergency Med, Crawley, WA 6009, Australia

[4] Royal Perth Hosp, Emergency Med, Perth, WA 6001, Australia

[5] Monash Univ, Dept Epidemiol & Prevent Med, Melbourne, Vic 3004, Australia

[6] Royal Perth Hosp, Harry Perkins Inst, Ctr Clin Res Emergency Med, Perth, WA 6847, Australia

[7] Univ Warwick, Warwick Clin Trials Unit, Coventry CV4 7AL, W Midlands, England

[8] Univ Warwick, Heart England NHS Fdn Trust, Coventry CV4 7AL, W Midlands, England

[9] Monash Univ, Dept Community Emergency Hlth & Paramed Practice, Melbourne, Vic 3004, Australia

[10] Ambulance Victoria, Blackburn North, Vic 3130, Australia

[11] Curtin Univ, Sch Educ, Bentley, WA 6102, Australia

关键词: Out-of-hospital cardiac arrest;    Recognition;    Agonal breathing;    Emergency medical services;    Dispatch;    Emergency calls;    Communication;    Conversation analysis;   

DOI  :  10.1016/j.resuscitation.2017.11.058

来源: Elsevier

【 摘 要 】

Background: In emergency ambulance calls, agonal breathing remains a barrier to the recognition of out-of-hospital cardiac arrest (OHCA), initiation of cardiopulmonary resuscitation, and rapid dispatch. We aimed to explore whether the language used by callers to describe breathing had an impact on call-taker recognition of agonal breathing and hence cardiac arrest. Methods: We analysed 176 calls of paramedic-confirmed OHCA, stratified by recognition of OHCA (89 cases recognised, 87 cases not recognised). We investigated the linguistic features of callers' response to the question is s/he breathing? and examined the impact on subsequent coding by call-takers. Results: Among all cases (recognised and non-recognised), 64% (113/176) of callers said that the patients were breathing (yes-answers). We identified two categories of yes-answers: 56% (63/113) were plain answers, confirming that the patient was breathing (he's breathing); and 44% (50/113) were qualified answers, containing additional information (yes but gasping). Qualified yes-answers were suggestive of agonal breathing. Yet these answers were often not pursued and most (32/50) of these calls were not recognised as OHCA at dispatch. Conclusion: There is potential for improved recognition of agonal breathing if call-takers are trained to be alert to any qualification following a confirmation that the patient is breathing. (c) 2017 Elsevier B.V. All rights reserved.

【 授权许可】

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