Abstract:

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.

Key words: Pre-hospital emergency care, Out-of-hospital cardiac arrest, Scheduling process