Accuracy of Recognition of Out of Hospital Cardiac Arrest by Narenthorn Emergency Medical service Center’s Call Handlers

Abstract

Introduction Sudden cardiac arrest is an emergency medical condition requiring immediate resuscitation. Early recognition of cardiac arrest and proper resuscitation are important factors to increase survival rate of OHCA

Objectives To evaluate accuracy of recognition of OHCA in unconscious patients and factors that associate with recognition of OHCA patients by Narenthorn Emergency Medical dispatcher center

Method This retrospective, diagnostic study includes 453 unconscious patients who were reported to Narenthorn Emergency Medical service Center and treated by emergency medical personnel in Bangkok from 1/1/2018 – 31/12/2021. Data was analysed to identify accuracy of recognition of OHCA by kappa coefficient and factors associated diagnosis of OHCA patients by multiple logistic regression analysis.

Results Accuracy between pre-arrival recognition of OHCA and actual OHCA is substantial with kappa coefficient 0.74 (95%CI: 0.674 - 0.806). Patients who were unconscious and apnea have greater risk of actual OHCA with adjusted odd ratio of 0.21 (95%CI: 0.09 - 0.50, p-value < 0.001) compared to patients who were only unconscious with no other symptoms.

Conclusion Accuracy of recognition of unconsciousness and OHCA is substantial. Reports of ‘unsciousness and apnea’ and, ‘unconsciousness’ were highly diagnosed OHCA.