Dispatch codes of out-of-hospital cardiac arrest should be diagnosis related rather than symptom related.
OBJECTIVE
To describe the characteristics and outcome in out-of-hospital cardiac arrest (OHCA) in relation to (i) whether OHCA was coded by the dispatcher as a diagnosis or as a symptom and (ii) the delay until the first unit was alerted at the dispatch centre.


METHODS
OHCA patients in Göteborg, during 17 months, excluding OHCA after calling the rescue team.


RESULTS
Among 250 cases, 20% were coded as a diagnosis (i.e. CA) with or without ongoing cardiopulmonary resuscitation (CPR). Dispatch codes for the remaining 200 patients (80%) were mostly symptom related (unconsciousness in 61%, codes related to breathing problems in 10%, other codes in 24% and missing in 5%). Patients in whom the dispatchers coded the call as CA had an earlier start to CPR after collapse (median 2 vs. 10 min; P<0.0001) and a higher rate of bystander CPR (86% vs. 42%; P<0.0001). Furthermore, they tended to have a higher rate of survival to hospital discharge (14.0% vs. 6.5%; P = 0.09). The median delay until the first unit was alerted was 1.8 min. Survival to hospital discharge was 10.0% if the delay was below median and 6.7% if the delay was above median (P = 0.48).


CONCLUSIONS
Patients with OHCA who were not coded by dispatchers as such had a long delay to the start of CPR and a low survival. Dispatching according to diagnosis, that is, CA seems to improve these parameters most likely reflecting a more optimal communication between the dispatcher and the caller as well as the rescue team.
Axelsson
Christer
C
Göteborg EMS System, Göteborg, Sweden.
Borgström
Jonas
J
Karlsson
Thomas
T
Axelsson
Asa B
AB
Herlitz
Johan
J
D000368:Aged; D002315:Cardiopulmonary Bypass; D016001:Confidence Intervals; D004631:Emergency Medical Service Communication Systems / Q000458:organization & administration*; D004632:Emergency Medical Services / Q000379:methods; D004634:Emergency Medical Technicians; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058687:Out-of-Hospital Cardiac Arrest / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013548:Sweden; D013997:Time Factors