title: Effect of protocol compliance to cardiac arrest identification by emergency medical dispatchers.
abstract: OBJECTIVE
  The objective of the study was to assess the effect of protocol compliance to the accuracy of cardiac arrest (CA) identification by the dispatchers.
  
  
  METHODS
  The study was conducted prospectively over a 1-year period in 1996. The calls categorized as non-traumatic CAs by the dispatcher and calls where the patient was in non-traumatic CA when ambulance crew arrived were included in the study. The data was collected from emergency call tape recordings and ambulance run sheets. The compliance to the protocol was defined as gathering information to two questions: (1) Is the patient awake or can she/he be awakened? and (2) Is she/he breathing normally?
  
  
  RESULTS
  The number of calls included in the study was 776 and the dispatchers identified 83% of the CAs. The protocol was adhered in 52.4% of calls, more often in witnessed than unwitnessed cases (72.3% versus 45.0%, P<0.001). In correctly identified CAs, the protocol compliance was 49.4%. The compliance was higher in cases of unidentified CAs (60.3%, P=0.0326) and in cases of wrongly identified as CAs (false positives, 61.9%, P=0.0276).
  
  
  CONCLUSIONS
  A high identification rate of CAs seems to be achievable despite poor protocol compliance by dispatchers.
authors.affiliation: Uusimaa EMS, Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Hospital, Finland. jouni.nurmi@helsinki.fi
authors.forename: Jouni
authors.initials: J
authors.lastname: Nurmi
authors.forename: Ville
authors.initials: V
authors.lastname: Pettilä
authors.forename: Björn
authors.initials: B
authors.lastname: Biber
authors.forename: Markku
authors.initials: M
authors.lastname: Kuisma
authors.forename: Rauni
authors.initials: R
authors.lastname: Komulainen
authors.forename: Maaret
authors.initials: M
authors.lastname: Castrén
mesh_terms: D000488:Allied Health Personnel / Q000592:standards*; D002985:Clinical Protocols / Q000592:standards*; D004631:Emergency Medical Service Communication Systems / Q000592:standards*; D005387:Finland; D019983:Guideline Adherence / Q000592:standards*; D006323:Heart Arrest / Q000175:diagnosis*; D006801:Humans