Abstract
Methods: Dispatch records, patient report forms, and hospital records were reviewed to determine patient outcome.
Results: Within the one year study period 141 emergency calls were coded as 09B01. Records were obtained for 59 of these cases (42%). Ambulance crews diagnosed 54 as beyond resuscitation (91.5%, 95% CI 79.5% to 96.2%). Three received resuscitation attempts (5.1%, 95% CI 1.1% to 14.2%): two were subsequently pronounced dead at scene and one on arrival at hospital. Two patients were not in cardiac arrest (3.4%, 95% CI 0.4% to 11.7%): one was a transiently unconscious assault victim, and one had a hand injury after a road accident. Three patients coded as 09B01 were transported to hospital for treatment other than confirmation of death (5.1%, 95% CI 1.1% to 14.2%).
Conclusion: Not all patients coded 09B01 by dispatchers are assessed as "dead beyond resuscitation" by attending ambulance crews. Although poor data recovery and a small sample size limited the study, its findings suggest that it is inappropriate to allocate a non-emergency response to 09B01 (obvious death) calls.
Full Text
The Full Text of this article is available as a PDF (87.4 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Clawson J. J., Cady G. A., Martin R. L., Sinclair R. Effect of a comprehensive quality management process on compliance with protocol in an emergency medical dispatch center. Ann Emerg Med. 1998 Nov;32(5):578–584. doi: 10.1016/s0196-0644(98)70036-8. [DOI] [PubMed] [Google Scholar]
- Eitel D. R., Walton S. L., Guerci A. D., Hess D. R., Sabulsky N. K. Out-of-hospital cardiac arrest: a six-year experience in a suburban-rural system. Ann Emerg Med. 1988 Aug;17(8):808–812. doi: 10.1016/s0196-0644(88)80560-2. [DOI] [PubMed] [Google Scholar]
- Fischer A. J., O'Halloran P., Littlejohns P., Kennedy A., Butson G. Ambulance economics. J Public Health Med. 2000 Sep;22(3):413–421. doi: 10.1093/pubmed/22.3.413. [DOI] [PubMed] [Google Scholar]
- Kahn C. A., Pirrallo R. G., Kuhn E. M. Characteristics of fatal ambulance crashes in the United States: an 11-year retrospective analysis. Prehosp Emerg Care. 2001 Jul-Sep;5(3):261–269. doi: 10.1080/10903120190939751. [DOI] [PubMed] [Google Scholar]
- Nichol G., Stiell I. G., Laupacis A., Pham B., De Maio V. J., Wells G. A. A cumulative meta-analysis of the effectiveness of defibrillator-capable emergency medical services for victims of out-of-hospital cardiac arrest. Ann Emerg Med. 1999 Oct;34(4 Pt 1):517–525. [PubMed] [Google Scholar]
- Stiell I. G., Wells G. A., DeMaio V. J., Spaite D. W., Field B. J., 3rd, Munkley D. P., Lyver M. B., Luinstra L. G., Ward R. Modifiable factors associated with improved cardiac arrest survival in a multicenter basic life support/defibrillation system: OPALS Study Phase I results. Ontario Prehospital Advanced Life Support. Ann Emerg Med. 1999 Jan;33(1):44–50. doi: 10.1016/s0196-0644(99)70415-4. [DOI] [PubMed] [Google Scholar]
- Swor R. A., Jackson R. E., Cynar M., Sadler E., Basse E., Boji B., Rivera-Rivera E. J., Maher A., Grubb W., Jacobson R. Bystander CPR, ventricular fibrillation, and survival in witnessed, unmonitored out-of-hospital cardiac arrest. Ann Emerg Med. 1995 Jun;25(6):780–784. doi: 10.1016/s0196-0644(95)70207-5. [DOI] [PubMed] [Google Scholar]
- Tanigawa K., Tanaka K., Shigematsu A. Outcomes of out-of-hospital ventricular fibrillation: their association with time to defibrillation and related issues in the defibrillation program in Japan. Resuscitation. 2000 Jul;45(2):83–90. doi: 10.1016/s0300-9572(00)00164-7. [DOI] [PubMed] [Google Scholar]