Expanding the first link in the chain of survival - Experiences from dispatcher referral of callers to AED locations

David Fredman; Leif Svensson; Yifang Ban; Martin Jonsson; Jacob Hollenberg; Per Nordberg; Mattias Ringh; Mårten Rosenqvist; Margareta Lundén; Andreas Claesson

doi:10.1016/j.resuscitation.2016.06.022

Expanding the first link in the chain of survival - Experiences from dispatcher referral of callers to AED locations

Resuscitation. 2016 Oct:107:129-34. doi: 10.1016/j.resuscitation.2016.06.022. Epub 2016 Jul 5.

Authors

Affiliations

¹ Karolinska Institutet, Center for Resuscitation Science, Department of Medicine, Solna and Unit of Cardiology, Södersjukhuset, SE-118 83 Stockholm, Sweden. Electronic address: david.a.fredman@ki.se.
² Karolinska Institutet, Center for Resuscitation Science, Department of Medicine, Solna and Unit of Cardiology, Södersjukhuset, SE-118 83 Stockholm, Sweden.
³ KTH - Royal Institute of Technology, Department of Urban Planning & Environment, Division of Geoinformatics, Stockholm, Sweden.
⁴ Karolinska Institutet, Department of Clinical Sciences, Danderyds Hospital, SE-182 88 Stockholm, Sweden.
⁵ SOS Alarm AB, SE-113 57 Stockholm, Sweden.

PMID: 27393179
DOI: 10.1016/j.resuscitation.2016.06.022

Abstract

Introduction: Early use of automated external defibrillators (AED) increases survival in cases of out-of-hospital cardiac arrest (OHCA). Dispatchers play important roles in identifying OHCA, dispatching ambulances and providing callers with telephone-assisted cardiopulmonary resuscitation. Guidelines recommend that AED registries be linked to dispatch centres as tools to refer callers to nearby AED.

Aim: The aim of this study was to investigate to what extent dispatchers, when provided with a tool to display AED locations and accessibility, referred callers to nearby AED.

Methods: An application providing real-time visualization of AED locations and accessibility was implemented at four dispatch centres in Sweden. Dispatchers were instructed to refer callers to nearby AED when OHCA was suspected. Such cases were prospectively collected, and geographic information systems were used to identify those located ≤100m from an AED. Audio recordings of emergency calls were assessed to evaluate the AED referral rate.

Results: Between February and August 2014, 3009 suspected OHCA calls were received. In 6.6% of those calls (200/3009), an AED was ≤100m from the suspected OHCA. The AED was accessible and the caller was not alone on scene in 24% (47/200) of these cases. In two of those 47 cases (4.3%), the dispatcher referred the caller to the AED.

Conclusion: Despite a tool for dispatchers to refer callers to a nearby AED, referral was rare. Only a minority of the suspected OHCA cases occurred ≤100m from an AED. We identified AED accessibility and callers being alone on scene as obstacles for AED referral.

Keywords: AED; Cardiopulmonary resuscitation; Defibrillation; Dispatch centre; Dispatcher; Out-of-hospital cardiac arrest.

Publication types

Observational Study

MeSH terms

Cardiopulmonary Resuscitation* / instrumentation
Cardiopulmonary Resuscitation* / methods
Defibrillators / statistics & numerical data*
Emergency Medical Dispatch / methods*
Emergency Medical Service Communication Systems / organization & administration
Geographic Information Systems / statistics & numerical data
Health Services Accessibility / organization & administration*
Humans
Out-of-Hospital Cardiac Arrest* / mortality
Out-of-Hospital Cardiac Arrest* / therapy
Outcome Assessment, Health Care
Sweden / epidemiology
Tape Recording / methods
Time-to-Treatment / statistics & numerical data