title: Emergency dispatch process and patient outcome in bystander-witnessed out-of-hospital cardiac arrest with a shockable rhythm.
abstract: OBJECTIVE
  To describe the dispatch process for out-of-hospital cardiac arrest (OHCA) in bystander-witnessed patients with initial shockable rhythm, and to evaluate whether recognition of OHCA by the emergency medical dispatcher (EMD) has an effect on the outcome.
  
  
  METHODS
  This study was part of the FINNRESUSCI study focusing on the epidemiology and outcome of OHCA in Finland. Witnessed [not by Emergency Medical Service (EMS)] OHCA patients with initial shockable rhythm in the southern and the eastern parts of Finland during a 6-month period from March 1 to August 31 2010, were electronically collected from eight dispatch centres and from paper case reports filled out by EMS crews.
  
  
  RESULTS
  Of the 164 patients, 82.3% (n=135) were correctly recognized by the EMD as cardiac arrests. The majority of all calls (90.7%) were dispatched within 2 min. Patients were more likely to survive and be discharged from the hospital if the EMS response time was within 8 min (P<0.001). Telephone-guided cardiopulmonary resuscitation (T-CPR) was given in 53 cases (32.3%). Overall survival to hospital discharge was 43.4% (n=71). Survival to hospital discharge was 44.4% (n=60) when the EMD recognized OHCA and 37.9% (n=11) when OHCA was not recognized. The difference was not statistically significant (P=0.521).
  
  
  CONCLUSIONS
  The rate of recognition of cardiac arrest by EMD was high, but EMD recognition did not affect the outcome. The survival rate was high in both groups. Recognized cardiac arrest patients received bystander CPR more frequently than those for whom OHCA remained unrecognized.
authors.affiliation: aCentre for Prehospital Emergency Care, Kuopio University Hospital, Kuopio bEmergency Medical Service, Department of Anaesthesia and ICM, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Pamela V C
authors.initials: PV
authors.lastname: Hiltunen
authors.forename: Tom O
authors.initials: TO
authors.lastname: Silfvast
authors.forename: T Helena
authors.initials: TH
authors.lastname: Jäntti
authors.forename: Markku J
authors.initials: MJ
authors.lastname: Kuisma
authors.forename: Jouni O
authors.initials: JO
authors.lastname: Kurola
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000401:mortality / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000379:methods; D004634:Emergency Medical Technicians / Q000706:statistics & numerical data; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D011446:Prospective Studies; D016019:Survival Analysis; D013997:Time Factors