Improving the Emergency Medical Service recognition and response for patients who are at imminent risk of out-of-hospital cardiac arrest

Kirby, Kim

Abstract

Current international guidelines and the associated “chain of survival” emphasise the recognition of critically unwell patients in the community followed by an efficient response in the hope of preventing out-of-hospital cardiac arrest, which occurs when the heart stops beating suddenly. This thesis investigates how Emergency Medical (ambulance) Services can improve their recognition and response to patients who are at imminent risk of out-of-hospital cardiac arrest to reduce mortality and improve outcomes.
Four distinct studies were completed:

a) Systematic mixed studies review;
b) Retrospective observational study of Emergency Medical Services call triage and the outcome of patients at imminent risk of out-of-hospital cardiac arrest;
c) Conversation analysis of the Emergency Medical Services call;
d) Interviews with Emergency Operations Centre staff.

This patient group is not well studied in the existing literature, with current research focusing on the recognition and response to individuals who have already suffered a cardiac arrest, even though people at imminent risk have a potentially better chance of survival.
Emergency Medical Dispatcher management of the Emergency Medical Services call is critical in the identification of these high-risk patients. Data analysis showed that Emergency Medical Services respond less urgently to patients at imminent risk of out-of-hospital cardiac arrest in comparison to patients already in cardiac arrest at the time of the call, with a negative impact on patient outcomes. The Emergency Medical Services interaction can be inefficient, leading to lost information.

Emergency Medical Dispatchers require enhanced education and clinical support, and opportunities to monitor deteriorating patients. Members of the public would benefit from education regarding the structure and process of the Emergency Medical Services call.
This thesis describes distinct areas where improvements can be made, and further research undertaken, in the recognition and response to patients in the community who are at imminent risk of out-of-hospital cardiac arrest.

Citation

Kirby, K. Improving the Emergency Medical Service recognition and response for patients who are at imminent risk of out-of-hospital cardiac arrest. (Thesis). University of the West of England. Retrieved from https://uwe-repository.worktribe.com/output/9030811

• Thesis Type: Thesis
• Deposit Date: Feb 18, 2022
• Publicly Available Date: Aug 12, 2022
• Keywords: Out-of-Hospital Cardiac Arrest, Emergency Medical Dispatch
• Public URL: https://uwe-repository.worktribe.com/output/9030811
• Award Date: Aug 12, 2022