ACCURACY OF DETERMINING CARDIAC-ARREST BY EMERGENCY MEDICAL DISPATCHERS

Study objective: To identify and determine the rates of delivery and p erformance of telephone CPR in noncardiac arrest incidents. Design: We studied prospectively all out-of-hospital cardiac arrest and potentia l cardiac arrest incidents from July 1 through October 31, 1992. Setti ng: King County, Washington, excluding the city of Seattle. Participan ts: Persons with cardiac arrest or an initial complaint resembling car diac arrest who received emergency medical services. Interventions: Di spatcher-assisted telephone CPR. Measurements and main results: Three hundred fifty-eight incidents of cardiac arrest, respiratory arrest, a nd potential cardiac arrest were reviewed. Telephone CPR was offered a ppropriately in 61 of 87 cases (70%) and inappropriately in eight of 1 54 potential cardiac arrests (5.2%) (95% confidence interval, 1.7%, 8. 7%). Ventilation instructions were performed appropriately in 52 of 87 cases (60%) and inappropriately in three of 154 potential cardiac arr ests (1.9%) (95% confidence interval, 0%, 4.1%). Chest compressions we re performed appropriately in 26 of 68 cardiac arrests (38.2%) and ina ppropriately in two of 173 potential cardiac arrests (1.2%) (95% confi dence interval, 0%, 2.8%). Conclusion: We found a low rate of performa nce of telephone CPR in King County for incidents resembling cardiac a rrest. This finding suggests that the protocols designed for dispatche r-assisted telephone CPR effectively screen out those incidents that m ay initially resemble cardiac arrest.