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Bottom line: Education to the public is needed to help to improve the information relayed to telecommunicators in an emergency. Further telecommunicator education can help to overcome the barriers within their control, such as the recognition of agonal breathing.
Additional Information
An important step in the chain of survival in cardiac arrest is recognition of an emergency. When a person calls 911, the telecommunicator needs to be able to obtain the necessary information to direct the right resource to the right patient and be able to deliver directions for CPR if required.
This study looked at 911 calls for pediatric patients who were in cardiac arrest on EMS arrival in Denmark over a 3 year period and identified 3 barriers to the recognition of the arrest by the telecommunicator.
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Prolonged conversations focused on the cause of the child's condition as opposed to assessmening consciousness and breathing.
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Assessing breathing when the patient has irregular or agonal breaths
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Callers who were unable to communicate or follow instructions from the telecommunicator.
References
Kragh AR, Kjærholm SH, de Claville Holland Flarup L, Juul Grabmayr A, Borch-Johnsen L, Folke F, Tjørnhøj-Thomsen T, Hassager C, Malta Hansen C. Barriers for Responding to Pediatric Out-of-Hospital Cardiac Arrest During Emergency Medical Calls: A Qualitative Study. J Am Heart Assoc. 2025 Jan 7;14(1):e035636. doi: 10.1161/JAHA.124.035636. Epub 2024 Dec 18. PMID: 39692033; PMCID: PMC12054490.