Dr Stephen Ball1,2, Dr Nirukshi Perera1, Ms Tanya Birnie1, Ms Alani Morgan1, Ms Sarah Tucknott1, Ms Lyndall Finn1, Dr David Majewski1, Mr Jason Belcher1,2, Ms Emilie Norton2, Ms Debbie Strachan2, Prof. Judith Finn1,2
1Curtin University, , Australia, 2St John WA, Belmont, Australia
Biography:
Prof Judith Finn is Director of the Prehospital, Resuscitation & Emergency Care Research Unit (PRECRU) in the Curtin School of Nursing, Perth, WA – St John WA being PRECRU’s principal research parter. Judith (critical care registered nurse and epidemiologist) was the inaugural Director of the Australasian Resuscitation Outcomes Consortium (Aus-ROC).
Abstract:
Introduction: Early call-taker recognition of out-of-hospital cardiac arrest (OHCA) in emergency calls is a key driver of patient survival; however, we currently know very little about the rates of OHCA recognition in Australia and New Zealand. This study provides a quantitative analysis of OHCA recognition in Western Australia (WA).
Methods: We analysed audio calls for 12 months of OHCA cases (1 April 2023 to 31 March 2024), identified from the St John WA OHCA Database. We excluded paediatric patients, traumatic arrests, cases dispatched as obvious deaths, cases where the caller was not with the patient, and where the patient was unequivocally alive during initial ‘case entry’ questions.
Results: Our cohort comprised 1018 cases. Overall, 95.5% of OHCA cases were recognised by call-takers, with a median time to recognition (from call answer) of 1.3 minutes (interquartile range 0.8–2.3 minutes). However, only 77.1% of cases were recognised during case entry, with a median recognition time of 1.1 minutes (IQR 0.8–1.6 minutes). In comparison, the 18.4% of cases recognised after case entry had a median recognition time of 3.7 minutes (IQR 2.8–5.4 minutes). Recognition during case entry was much less likely among bystander-witnessed than unwitnessed arrests (54.8% vs 91.8%; p<0.001).
Conclusion: This study highlights the importance of looking beyond the overall percentage of OHCA cases recognised during calls. While more than 95% of OHCA cases in WA were recognised by call-takers, only 77% were recognised during initial case entry questioning. Early recognition appears more challenging among bystander-witnessed than unwitnessed arrests.