Seizure-like presentation in OHCA creates barriers to dispatch recognition of cardiac arrest

Seizure-like presentation in OHCA creates barriers to dispatch recognition of cardiac arrest

Early recognition of out-of-hospital cardiac arrest (OHCA) by 9-1-1 dispatchers is a critical first step along the resuscitation pathway. Barriers to recognition may lead to adverse outcomes among patients. This study aims to determine the impact of seizure-like activity among OHCA patients during 9...

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Veröffentlicht in:Resuscitation 2020-11, Vol.156, p.230-236
Hauptverfasser: Schwarzkoph, Madison, Yin, Lihua, Hergert, Lindsey, Drucker, Christopher, Counts, Catherine R., Eisenberg, Mickey
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Sprache:eng
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Cardiac arrest
Dispatcher
OHCA
Seizure
TCPR
Telephone-CPR
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container_end_page 236
container_issue
container_start_page 230
container_title Resuscitation
container_volume 156
creator Schwarzkoph, Madison
Yin, Lihua
Hergert, Lindsey
Drucker, Christopher
Counts, Catherine R.
Eisenberg, Mickey
description Early recognition of out-of-hospital cardiac arrest (OHCA) by 9-1-1 dispatchers is a critical first step along the resuscitation pathway. Barriers to recognition may lead to adverse outcomes among patients. This study aims to determine the impact of seizure-like activity among OHCA patients during 9-1-1 calls. We evaluated a retrospective cohort study of all adult, non-traumatic OHCAs that occurred prior to emergency medical services (EMS) arrival on scene in a major metropolitan area from 2014–2018. Dispatch recordings were reviewed to determine if seizure-like activity was reported by the caller using key descriptor phrases such as “seizing,” “shaking,” or “convulsing.” We compared patient demographics, arrest factors, and hospital outcomes using a regional OHCA quality improvement database. Among 3502 OHCAs meeting our inclusion criteria, 149 (4.3%) contained seizure-like activity. When compared to patients without seizure-like activity (3353; 95.7%), patients presenting with seizure-like activity were younger (54 vs. 66 years old; p 
doi_str_mv 10.1016/j.resuscitation.2020.06.036
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When compared to patients without seizure-like activity (3353; 95.7%), patients presenting with seizure-like activity were younger (54 vs. 66 years old; p &lt; 0.05), had a witnessed arrest (88% vs 45%; p &lt; 0.05), presented with an initial shockable rhythm (52% vs. 24%; p &lt; 0.05), and survived to hospital discharge (44% vs. 16%; p &lt; 0.05). The seizure-like activity group also had a longer median time to dispatcher identification of the cardiac arrest [130 s (72,193) vs 62 s (43,102); p &lt; 0.05]. 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subjects Cardiac arrest
Dispatcher
OHCA
Seizure
TCPR
Telephone-CPR
title Seizure-like presentation in OHCA creates barriers to dispatch recognition of cardiac arrest
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