Predictors of recognition of out of hospital cardiac arrest by emergency medical services call handlers in England: a mixed methods diagnostic accuracy study

Abstract Background The aim of this study was to identify key indicator symptoms and patient factors associated with correct out hospital cardiac arrest (OHCA) dispatch allocation. In previous studies, from 3% 62% OHCAs are not recognised by Emergency Medical Service call handlers, resulting in delayed arrival at scene. Methods Retrospective, mixed methods including all suspected or confirmed OHCA patients transferred one acute its regional England 1/7/2013 30/6/2014. data, voice recordings EMS calls, were analysed predictors recognition handlers. Logistic regression used explore the role most frequently occurring (key) characteristics predicting a for OHCA. Results A total 39,136 dispatches made which resulted transfer within period, 184 use term ‘Unconscious’ plus more ‘Not breathing/Ineffective breathing/Noisy breathing’ occurred 79.8% OHCAs, but only 72.8% correctly dispatched as such. handlers (Odds Ratio (OR) 3.76). presence ‘Breathing’ (OR 0.29), ‘Reduced fluctuating level consciousness’ 0.24), abnormal pulse/heart rate 0.26) characteristic ‘Female patient’ 0.40) lack ( p -values < 0.05). Conclusions There is small proportion calls indicators described Stricter adherence protocols may improve handlers’ recognition. existing protocol would be improved addition further terms expense specificity.