Emergency Operation Centre staff views on identifying patients at imminent risk of out-of-hospital cardiac arrest during the Emergency Medical Service call for help

Kirby, Kim; Voss, Sarah; Benger, Jonathan

Abstract

Background 

Internationally, Emergency Medical Service (EMS) triage emergency calls so that healthcare resources can be allocated appropriately. Studies have indicated that call triage in EMS may trigger a suboptimal response to some patients with life threatening conditions. The triage of emergency calls is an important element of the “Chain of Survival” in OHCA and in the recognition of deteriorating patients.

The aim of this study was to investigate Emergency Operation Centre (EOC) staff views on the barriers to identification, and how to improve the early identification of patients contacting EMS who are at imminent risk of cardiac arrest.

Methods 

This was a qualitative study using interviews and focus groups with EOC employees. Two UK EMS participated in the research.  We aimed to recruit 20 participants to the study using purposive sampling.



Reflexive thematic analysis (RTA) was used to analyse the data using a combined inductive and deductive approach. The deductive and inductive analyses were combined into the final overarching themes and sub themes. Themes were identified where there was a central organising concept.   

Results 

Twelve semi-structured interviews were completed between July and September 2021. Four participants also took part in a focus group in September 2021.



Three main themes were identified: The dispatch protocol and EMD audit; Identifying and responding to deteriorating patients; Education, knowledge and skills.  Each of these main themes were broken into sub-themes.



Conclusions 

Participants identified several barriers to recognizing patients at imminent risk of OHCA, including the restrictive dispatch protocol, lack of opportunity to monitor a patient, compliance auditing and inadequate clinical and communication education. Participants reported that clinician support for the EMD role was not always adequate. Callers are unaware of the structure of the EMS call which leads to initial confusion and a lack of patient outcome feedback restricts EMD learning and development.

• Presentation Conference Type: Poster
• Conference Name: 999 EMS
• Start Date: Jun 20, 2023
• End Date: Jun 21, 2023
• Deposit Date: Aug 15, 2023
• Publicly Available Date: Aug 30, 2023
• Public URL: https://uwe-repository.worktribe.com/output/10947838