Comparison of Medical Priority Dispatch (MPD) and Criteria Based Dispatch (CBD) relating to cardiac arrest calls

RESUSCITATION

卷:85

Article

Hardeland, Camilla¹  Olasveengen, Theresa M.^3,2  Lawrence, Rob⁴  Garrison, Danny⁴  Lorem, Tonje⁵  Farstad, Gunnar^6,7  Wik, Lars⁸ 

[1] Univ Oslo, Inst Clin Med, N-0318 Oslo, Norway

[2] Oslo Univ Hosp, Expt Med Res Inst, N-0424 Oslo, Norway

[3] Oslo Univ Hosp, Dept Anaesthesiol, N-0424 Oslo, Norway

[4] Richmond Ambulance Author, Richmond, VA 23220 USA

[5] Municipal Skedsmo, N-2000 Lillestrom, Norway

[6] Oslo Univ Hosp, Emergency Med Commun Ctr, N-0424 Oslo, Norway

[7] Oslo Univ Hosp, Air Ambulance Dept, N-0424 Oslo, Norway

[8] Oslo Univ Hosp, Natl Ctr Prehosp Emergency Med, N-0424 Oslo, Norway

关键词: Dispatch;    Cardiac arrest;    Resuscitation;    Medical Priority Dispatch;    Criteria Based Dispatch;    EMS;   

DOI  :  10.1016/j.resuscitation.2014.01.029

来源: Elsevier

【 摘 要 】

Background: Prompt emergency medical service (EMS) system activation with rapid delivery of pre-hospital treatment is essential for patients suffering out-of-hospital cardiac arrest (OHCA). The two most commonly used dispatch tools are Medical Priority Dispatch (MPD) and Criteria Based Dispatch (CBD). We compared cardiac arrest call processing using these two dispatch tools in two different dispatch centres. Methods: Observational study of adult EMS confirmed (non-EMS witnessed) OHCA calls during one year in Richmond, USA (MPD) and Oslo, Norway (CBD). Patients receiving CPR prior to call, interrupted calls or calls where the caller did not have access to the patients were excluded from analysis. Dispatch logs, ambulance records and digitalized dispatcher and caller voice recordings were compared. Results: The MPDS-site processed 182 cardiac arrest calls and the CBD-site 232, of which 100 and 140 calls met the inclusion criteria, respectively. The recognition of cardiac arrest was not different in the MPD and CBD systems; 82% vs. 77% (p = 0.42), and pre-EMS arrival CPR instructions were offered to 81% vs. 74% (p = 0.22) of callers, respectively. Time to ambulance dispatch was median (95% confidence interval) 15 (13, 17) vs. 33 (29, 36) seconds (p < 0.001) and time to chest compression delivery; 4.3 (3.7, 4.9) vs. 3.7 (3.0, 4.1) min for the MPD and CBD systems, respectively (p = 0.05). Conclusion: Pre-arrival CPR instructions were offered faster and more frequently in the CBD system, but in both systems chest compressions were delayed 3-4 min. Earlier recognition of cardiac arrest and improved CPR instructions may facilitate earlier lay rescuer CPR. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

Free