Dispatcher-assisted telephone CPR: a qualitative study exploring how dispatchers perceive their experiences.
OBJECTIVE
To investigate how emergency medical dispatchers (EMDs) perceive their experience of identifying suspected cardiac arrests (CA), and offer and provide instructions in cardiopulmonary resuscitation via telephone (t-CPR).


METHODS
A qualitative method using the phenomenographic design where 10 EMDs were approached for semi-structured interviews.


METHODS
Perception in identifying CA, perception in offering t-CPR and perception in providing t-CPR.


RESULTS
In this analysis, 12 categories and 31 subcategories emerged. The categories for perception in identifying CA were; to trust the witness's account, to be open-minded and to be organised. The categories for perception in offering t-CPR were: to feel prepared to connect with the witness on a mental level by being organised, flexible and supportive, to obtain a basis for assessments and to be observant for diverse obstacles in a situation. Finally, the categories for perception in providing t-CPR were: to feel engaged, to be supportive of the witness, to feel secure by recognising response-feedback from the witness, to observe external conditions with regard to the locality and technical complications, to be composed and adjust to the needs of the situation, to feel competent or to feel despair.


CONCLUSIONS
By listening in an open-minded way, a vast amount of information can be collected. Using criteria-based dispatch (CBD) and their own resources, the possibilities and difficulties of the situation are analysed. The EMDs believe that they are being an empathic support, relieving the witness of the burden of responsibility, and connecting with them mentally to enable them to act at the scene. There are EMDs who feel competent and experienced in managing these cases, and other EMDs who feel insecure and despair. The choice between providing t-CPR and answering incoming calls is prioritised differently among EMDs. There is also a broad subjective assessment among EMDs of offering t-CPR, especially to persons over 70 years old whom they consider incapable of performing CPR. The competence of the EMDs in t-CPR is dependent on re-training and a feedback on patient outcome. Witnesses who are negative towards acting constitute a common problem. There are witnesses with physical impediments or psychologically not susceptible to suggestions. The EMD is also dependent on the knowledge and trustworthiness of the witness. Convincing answers from witnesses prompt a more secure feeling in the EMDs, just as lack of knowledge in the witness has a negative effect on the efforts.
Bång
Angela
A
Department of Cardiology, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden. angela.bang@hjl.gu.se
Ortgren
P-O
PO
Herlitz
Johan
J
Währborg
Peter
P
D001291:Attitude of Health Personnel; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004631:Emergency Medical Service Communication Systems; D004634:Emergency Medical Technicians / Q000523:psychology*; D005260:Female; D006323:Heart Arrest / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D013689:Telephone