目的

调查成都市中心城区院前急救对院外心脏骤停患者在接警、调度及院前电话指导三大调度指挥流程的执行现状，分析原因，并提出针对性的改进措施。

方法

（1）回顾性分析2021 年9 月1 日～2023 年8 月30 日成都120 院前急救医生到现场诊断为“心脏骤停”的85 例患者资料，分析呼救原因的准确度对急救反应时间的影响。（2）对147 名成都市120 调度员及2309 名市级网络医院院前急救人员进行问卷调查，分析相关数据。

结果

（1）接警：对于院前心脏骤停患者呼救原因主要分为三种：晕厥、昏迷、心跳呼吸停止/死亡，不同呼救原因下急救反应时间、到达现场时间有显著性差异（P=0.002），其中心跳呼吸停止/死亡组具有更短的急救反应时间和到达现场时间。（2）调度：调度员和急救出诊人员在四大不同调度原则的重要性认知上存在显著性差异（P＜0.001），急救出诊人员中认为满足专业需要最重要的占比更高，为11.35%，差异有统计学意义（P=0.026）。（3）院前电话指导：65.31%的调度员会在院前急救中电话指导徒手心肺复苏，而83.67%的调度员不会指导AED 的使用，随着年龄的增加，电话指导率升高。

结论

调度员应使用更为快速有效的沟通方式并通过指导旁观者判断等提高院外心脏骤停的识别率，将呼救原因更为准确地传达给急救人员；调度员应根据实际情况灵活运用调度原则；需从不同角度采取措施提高调度员对院前心肺复苏的电话指导率。

Objective

To investigate the implementation of the three major command and dispatch processes of emergency care for out-of-hospital cardiac arrest （OHCA） patients in the central urban area of Chengdu， including alarm reception， dispatch， and pre-hospital telephone guidance， and to analyze the reasons and propose targeted improvement measures.

Methods

The data of 85 patients who were diagnosed as having “cardiac arrest” by Chengdu 120 pre-hospital emergency doctors on the scene from September 1， 2021 to August 30， 2023 were retrospectively analyzed， and analyze the effect of the accuracy of reasons for calling for help on the emergency response time.A questionnaire survey was conducted on 147 Chengdu 120 dispatchers and 2309 pre-hospital emergency personnel of municipal network hospitals，and relevant data were analyzed.

Results

With regard to alarm reception， for patients with cardiac arrest，the reasons for calling for help can be divided into three kinds： syncope， coma， and cardiac and respiratory arrest/death.There was a significant difference in the length of first aid response and the length of time of arriving at the scene among different reasons for calling for help （P=0.002）， and both were shorter in the cardiac and respiratory arrest/death group.Regarding dispatch， there was a significant difference in the perceived importance of scheduling principles between dispatchers and pre-hospital emergency personnel（P＜0.001）， with a significantly higher percentage of pre-hospital emergency personnel believing that meeting professional needs was most important at 11.35% （P=0.026）.For pre-hospital telephone guidance， 65.31% of dispatchers provided telephone guidance for hands-only cardiopulmonary resuscitation （CPR）， while 83.67%did not provide guidance on automated external defibrillator （AED） usage.The rate of telephone guidance rose with age.

Conclusion

Dispatchers should use faster and more effective communication methods and improve the recognition rate of OHCA by guiding the judgment of bystanders to more accurately understand the cause of the call to the emergency personnel； dispatchers should flexibly apply the dispatch principles according to the actual situation； and measures need to be taken to improve the rate of telephone guidance for CPR by dispatchers from different perspectives.