‘I think he’s dead’: A cohort study of the impact of caller declarations of death during the emergency call on bystander CPR.
Background: In emergency calls for out-of-hospital cardiac arrest (OHCA), dispatchers are instrumental in the provision of bystander cardiopulmonary resuscitation (CPR) through the recruitment of the caller. We explored the impact of caller perception of patient viability on initial recognition of O...
| Main Authors: | , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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Elsevier
2021
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| Subjects: | |
| Online Access: | http://purl.org/au-research/grants/nhmrc/1116453 http://hdl.handle.net/20.500.11937/93244 |
| _version_ | 1848765717714829312 |
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| author | Riou, Marine Ball, Stephen Morgan, Alani Gallant, Sheryl Perera, Niru Whiteside, Austin Bray, Janet Bailey, Paul Finn, Judith |
| author_facet | Riou, Marine Ball, Stephen Morgan, Alani Gallant, Sheryl Perera, Niru Whiteside, Austin Bray, Janet Bailey, Paul Finn, Judith |
| author_sort | Riou, Marine |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background: In emergency calls for out-of-hospital cardiac arrest (OHCA), dispatchers are instrumental in the provision of bystander cardiopulmonary resuscitation (CPR) through the recruitment of the caller. We explored the impact of caller perception of patient viability on initial recognition of OHCA by the dispatcher, rates of bystander CPR and early patient survival outcomes. Methods: We conducted a retrospective cohort study of 422 emergency calls where OHCA was recognised by the dispatcher and resuscitation was attempted by paramedics. We used the call recordings, dispatch data, and electronic patient care records to identify caller statements that the patient was dead, initial versus delayed recognition of OHCA by the dispatcher, caller acceptance to perform CPR, provision of bystander-CPR, prehospital return of spontaneous circulation (ROSC), and ROSC on arrival at the Emergency Department. Results: Initial recognition of OHCA by the dispatcher was more frequent in cases with a declaration of death by the caller than in cases without (92%, 73/79 vs. 66%, 227/343, p < 0.001). Callers who expressed such a view (19% of cases) were more likely to decline CPR (38% vs. 10%, adjusted odds ratio 4.59, 95% confidence interval 2.49–8.52, p < 0.001). Yet, 15% (12/79) of patients described as non-viable by callers achieved ROSC. Conclusion: Caller statements that the patient is dead are helpful for dispatchers to recognise OHCA early, but potentially detrimental when recruiting the caller to perform CPR. There is an opportunity to improve the rate of bystander-CPR and patient outcomes if dispatchers are attentive to caller statements about viability. |
| first_indexed | 2025-11-14T11:39:41Z |
| format | Journal Article |
| id | curtin-20.500.11937-93244 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:39:41Z |
| publishDate | 2021 |
| publisher | Elsevier |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-932442023-10-09T00:09:24Z ‘I think he’s dead’: A cohort study of the impact of caller declarations of death during the emergency call on bystander CPR. Riou, Marine Ball, Stephen Morgan, Alani Gallant, Sheryl Perera, Niru Whiteside, Austin Bray, Janet Bailey, Paul Finn, Judith Science & Technology Life Sciences & Biomedicine Critical Care Medicine Emergency Medicine General & Internal Medicine Out-of-hospital cardiac arrest Cardiopulmonary resuscitation Bystander-CPR Telephone-CPR Barrier Viability Dispatcher Emergency call Communication Barrier Bystander-CPR Cardiopulmonary resuscitation Communication Dispatcher Emergency call Out-of-hospital cardiac arrest Telephone-CPR Viability Cardiopulmonary Resuscitation Cohort Studies Emergency Medical Services Emergency Service, Hospital Humans Male Out-of-Hospital Cardiac Arrest Retrospective Studies Humans Cardiopulmonary Resuscitation Retrospective Studies Cohort Studies Emergency Service, Hospital Emergency Medical Services Male Out-of-Hospital Cardiac Arrest Background: In emergency calls for out-of-hospital cardiac arrest (OHCA), dispatchers are instrumental in the provision of bystander cardiopulmonary resuscitation (CPR) through the recruitment of the caller. We explored the impact of caller perception of patient viability on initial recognition of OHCA by the dispatcher, rates of bystander CPR and early patient survival outcomes. Methods: We conducted a retrospective cohort study of 422 emergency calls where OHCA was recognised by the dispatcher and resuscitation was attempted by paramedics. We used the call recordings, dispatch data, and electronic patient care records to identify caller statements that the patient was dead, initial versus delayed recognition of OHCA by the dispatcher, caller acceptance to perform CPR, provision of bystander-CPR, prehospital return of spontaneous circulation (ROSC), and ROSC on arrival at the Emergency Department. Results: Initial recognition of OHCA by the dispatcher was more frequent in cases with a declaration of death by the caller than in cases without (92%, 73/79 vs. 66%, 227/343, p < 0.001). Callers who expressed such a view (19% of cases) were more likely to decline CPR (38% vs. 10%, adjusted odds ratio 4.59, 95% confidence interval 2.49–8.52, p < 0.001). Yet, 15% (12/79) of patients described as non-viable by callers achieved ROSC. Conclusion: Caller statements that the patient is dead are helpful for dispatchers to recognise OHCA early, but potentially detrimental when recruiting the caller to perform CPR. There is an opportunity to improve the rate of bystander-CPR and patient outcomes if dispatchers are attentive to caller statements about viability. 2021 Journal Article http://hdl.handle.net/20.500.11937/93244 10.1016/j.resuscitation.2021.01.001 English http://purl.org/au-research/grants/nhmrc/1116453 http://purl.org/au-research/grants/nhmrc/1174838 http://purl.org/au-research/grants/nhmrc/101171 http://creativecommons.org/licenses/by-nc-nd/4.0/ Elsevier fulltext |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Critical Care Medicine Emergency Medicine General & Internal Medicine Out-of-hospital cardiac arrest Cardiopulmonary resuscitation Bystander-CPR Telephone-CPR Barrier Viability Dispatcher Emergency call Communication Barrier Bystander-CPR Cardiopulmonary resuscitation Communication Dispatcher Emergency call Out-of-hospital cardiac arrest Telephone-CPR Viability Cardiopulmonary Resuscitation Cohort Studies Emergency Medical Services Emergency Service, Hospital Humans Male Out-of-Hospital Cardiac Arrest Retrospective Studies Humans Cardiopulmonary Resuscitation Retrospective Studies Cohort Studies Emergency Service, Hospital Emergency Medical Services Male Out-of-Hospital Cardiac Arrest Riou, Marine Ball, Stephen Morgan, Alani Gallant, Sheryl Perera, Niru Whiteside, Austin Bray, Janet Bailey, Paul Finn, Judith ‘I think he’s dead’: A cohort study of the impact of caller declarations of death during the emergency call on bystander CPR. |
| title | ‘I think he’s dead’: A cohort study of the impact of caller declarations of death during the emergency call on bystander CPR. |
| title_full | ‘I think he’s dead’: A cohort study of the impact of caller declarations of death during the emergency call on bystander CPR. |
| title_fullStr | ‘I think he’s dead’: A cohort study of the impact of caller declarations of death during the emergency call on bystander CPR. |
| title_full_unstemmed | ‘I think he’s dead’: A cohort study of the impact of caller declarations of death during the emergency call on bystander CPR. |
| title_short | ‘I think he’s dead’: A cohort study of the impact of caller declarations of death during the emergency call on bystander CPR. |
| title_sort | ‘i think he’s dead’: a cohort study of the impact of caller declarations of death during the emergency call on bystander cpr. |
| topic | Science & Technology Life Sciences & Biomedicine Critical Care Medicine Emergency Medicine General & Internal Medicine Out-of-hospital cardiac arrest Cardiopulmonary resuscitation Bystander-CPR Telephone-CPR Barrier Viability Dispatcher Emergency call Communication Barrier Bystander-CPR Cardiopulmonary resuscitation Communication Dispatcher Emergency call Out-of-hospital cardiac arrest Telephone-CPR Viability Cardiopulmonary Resuscitation Cohort Studies Emergency Medical Services Emergency Service, Hospital Humans Male Out-of-Hospital Cardiac Arrest Retrospective Studies Humans Cardiopulmonary Resuscitation Retrospective Studies Cohort Studies Emergency Service, Hospital Emergency Medical Services Male Out-of-Hospital Cardiac Arrest |
| url | http://purl.org/au-research/grants/nhmrc/1116453 http://purl.org/au-research/grants/nhmrc/1116453 http://purl.org/au-research/grants/nhmrc/1116453 http://hdl.handle.net/20.500.11937/93244 |