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

Abstract

Background Dispatch services (DSs) 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 DSs, 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 DSs.

Results 9 DSs responded, representing a total of 23 dispatch centres from 9 countries that serve over 80 million people. Most PAROS DSs operate a tiered dispatch response, have implemented medical oversight, and tend to be staffed by dispatchers with a predominantly medical background. Almost all PAROS DSs have begun tracking key EMS indicators. 77.8% (n = 7) of PAROS DSs have introduced DACPR. Of the DSs that have rolled out DACPR, 71.4% (n = 5) provided instructions in over one language. All DSs that implemented DACPR and provided feedback to dispatchers offered feedback on missed OHCA recognition. The majority of DSs (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 DSs. OHCA recognition sensitivity varied widely in PAROS DSs, 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 DSs. These findings will lay the groundwork for future DS and DACPR studies in the PAROS network.