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Emergency medical dispatch services across Pan-Asian countries: a web-based survey

Lee SCL 1 , Mao DR 2 , Ng YY 3 , Leong BS 4 , Supasaovapak J 5 , Gaerlan FJ 6 Show all authors , Son DN 7 , Chia BY 8 , Do Shin S 9 , Lin CH 10 , Rao GVR 11 , Hara T 12 , Ong MEH 13 , PAROS Clinical Research Network

Affiliations 

  • 1 UNSW Medicine, University of New South Wales, Sydney, New South Wales, 2033, Australia. [email protected]
  • 2 Department of Acute and Emergency Care, Khoo Teck Puat Hospital, Singapore, Singapore
  • 3 Medical Department, Singapore Civil Defence Force, Singapore, Singapore
  • 4 Emergency Medicine Department, National University Hospital, Singapore, Singapore
  • 5 Narenthorn EMS Center, Rajavithi Hospital, Bangkok, Thailand
  • 6 Southern Philippines Medical Center, Davao, Philippines
  • 7 Bach Mai Hospital, Hanoi, Vietnam
  • 8 Emergency and Trauma Department, Miri Hospital, Miri, Sarawak, Malaysia
  • 9 Seoul National University College of Medicine, Seoul, South Korea
  • 10 Department of Emergency Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
  • 11 GVK Emergency Management and Research Institute (GVK EMRI), Secunderabad, Telangana, India
  • 12 Graduate School of Emergency Medical System, Kokushikan University, Tokyo, Japan
  • 13 Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
BMC Emerg Med, 2020 01 07;20(1):1.
PMID: 31910801 DOI: 10.1186/s12873-019-0299-1

Abstract

BACKGROUND: Dispatch services (DS's) form an integral part of emergency medical service (EMS) systems. The role of a dispatcher has also evolved into a crucial link in patient care delivery, particularly in dispatcher assisted cardio-pulmonary resuscitation (DACPR) during out-of-hospital cardiac arrest (OHCA). Yet, there has been a paucity of research into the emerging area of dispatch science in Asia. This paper compares the characteristics of DS's, and state of implementation of DACPR within the Pan-Asian Resuscitation Outcomes (PAROS) network.

METHODS: A cross-sectional descriptive survey addressing population characteristics, DS structures and levels of service, state of DACPR implementation (including protocols and quality improvement programs) among PAROS DS's.

RESULTS: 9 DS's responded, representing a total of 23 dispatch centres from 9 countries that serve over 80 million people. Most PAROS DS's operate a tiered dispatch response, have implemented medical oversight, and tend to be staffed by dispatchers with a predominantly medical background. Almost all PAROS DS's have begun tracking key EMS indicators. 77.8% (n = 7) of PAROS DS's have introduced DACPR. Of the DS's that have rolled out DACPR, 71.4% (n = 5) provided instructions in over one language. All DS's that implemented DACPR and provided feedback to dispatchers offered feedback on missed OHCA recognition. The majority of DS's (83.3%; n = 5) that offered DACPR and provided feedback to dispatchers also implemented corrective feedback, while 66.7% (n = 4) offered positive feedback. Compression-only CPR was the standard instruction for PAROS DS's. OHCA recognition sensitivity varied widely in PAROS DS's, ranging from 32.6% (95% CI: 29.9-35.5%) to 79.2% (95% CI: 72.9-84.4%). Median time to first compression ranged from 120 s to 220 s.

CONCLUSIONS: We found notable variations in characteristics and state of DACPR implementation between PAROS DS's. These findings will lay the groundwork for future DS and DACPR studies in the PAROS network.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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