title: The accuracy of emergency medical dispatcher-assisted layperson-caller pulse check using the medical priority dispatch system protocol.
abstract: BACKGROUND
  Knowing the pulse rate of a patient in a medical emergency can help to determine patient acuity and the level of medical care required. Little evidence exists regarding the ability of a 911 layperson-caller to accurately determine a conscious patient's pulse rate. Hypothesis The hypothesis of this study was that, when instructed by a trained emergency medical dispatcher (EMD) using the scripted Medical Priority Dispatch System (MPDS) protocol Pulse Check Diagnostic Tool (PCDxT), a layperson-caller can detect a carotid pulse and accurately determine the pulse rate in a conscious person.
  
  
  METHODS
  This non-randomized and non-controlled prospective study was conducted at three different public locations in the state of Utah (USA). A healthy, mock patient's pulse rate was obtained using an electrocardiogram (ECG) monitor. Layperson-callers, in turn, initiated a simulated 911 phone call to an EMD call-taker who provided instructions for determining the pulse rate of the patient. Layperson accuracy was assessed using correlations between the layperson-caller's finding and the ECG reading.
  
  
  RESULTS
  Two hundred sixty-eight layperson-callers participated; 248 (92.5%) found the pulse of the mock patient. There was a high correlation between pulse rates obtained using the ECG monitor and those found by the layperson-callers, overall (94.6%, P < .001), and by site, gender, and age.
  
  
  CONCLUSIONS
  Layperson-callers, when provided with expert, scripted instructions by a trained 911 dispatcher over the phone, can accurately determine the pulse rate of a conscious and healthy person. Improvements to the 911 instructions may further increase layperson accuracy.
authors.affiliation: International Academies of Emergency Dispatch, Salt Lake City, UT, USA. greg.scott@emergencydispatch.org
authors.forename: Greg
authors.initials: G
authors.lastname: Scott
authors.forename: Jeff
authors.initials: J
authors.lastname: Clawson
authors.forename: Mark
authors.initials: M
authors.lastname: Rector
authors.forename: Dave
authors.initials: D
authors.lastname: Massengale
authors.forename: Mike
authors.initials: M
authors.lastname: Thompson
authors.forename: Brett
authors.initials: B
authors.lastname: Patterson
authors.forename: Christopher H O
authors.initials: CH
authors.lastname: Olola
mesh_terms: D000293:Adolescent; D000328:Adult; D002339:Carotid Arteries; D002985:Clinical Protocols; D004562:Electrocardiography; D004631:Emergency Medical Service Communication Systems; D005260:Female; D006801:Humans; D008297:Male; D016544:Patient Simulation; D011446:Prospective Studies; D011674:Pulse; D018570:Risk Assessment; D014584:User-Computer Interface