South African Journal of Pre-Hospital Emergency Care

The Ides of March

Christopher Stein — Mon, 16 Oct 2023 00:00:00 +0000

Telephonic descriptions of out-of-hospital cardiac arrest by laypersons calling the dispatch centre of a private emergency medical service in South Africa

Stephanie Crause, Helen Slabber, Elzarie Theron, Willem Stassen — Wed, 13 Sep 2023 00:00:00 +0000

Background: The incidence of out-of-hospital cardiac arrest (OHCA) is expected to increase in South Africa. In order to encourage bystander cardiopulmonary resuscitation (CPR), international guidelines recommend call-taker recognition of the arrest and the initiation of telephone-guided CPR. One of the only ways that a call-taker can identify OHCA is through the description of the incident offered by the caller. The aim of this study was to identify the keywords and phrases that are used by callers to describe patients who are experiencing OHCA during calls made to a South African private Emergency Medical Service (EMS).

Methods: A qualitative exploratory design was used and employed inductive dominant content analysis to identify the keywords and phrases that are used by callers to describe patients who are experiencing OHCA during calls made to a South African private EMS. The initial sampling frame was all cases of the “Cardiac Arrest” incident type recorded between 1 January 2019 and 31 December 2019.

Results: A total of 28 call recordings were analysed. Keywords and phrases were organised into five categories: 1) Cardiac activity; 2) Level of consciousness; 3) Breathing descriptors; 4) Ill health; and 5) Clinical features.

Conclusion: Callers into a private emergency dispatch centre used consistent descriptors of OHCA, which were similar to those found in previous South African studies. Future research should focus on determining the accuracy of these descriptors to differentiate between OHCA and other conditions, and integrate them into OHCA recognition algorithms, call-taker training and telephone-guided CPR protocols.

Emergency Medical Service response and mission times in an African metropolitan setting

Wynand Van Der Net, Craig Vincent-Lambert, Kevin Govender — Mon, 16 Oct 2023 00:00:00 +0000

Background: Emergency Medical Services (EMS) aim to respond to emergencies, treat and transport patients efficiently thus ensuring the ambulance call or “mission” is completed with ambulances available to service the next call as soon as possible. A typical mission may be divided into activities, each linked to a set time interval. The response time interval starts from the time a call is received by the call centre until the ambulance arrives on scene. The patient care interval includes the time taken to treat and transport the patient to hospital. The total mission time can be viewed as the time from when a call is first received by the call centre until the ambulance dispatched to that incident is again available to service the next call. The aim of this study was to describe response interval, patient care interval and total mission times routinely associated with servicing emergency incidents within a metropolitan public sector EMS in South Africa.

Methods: A quantitative, prospective, descriptive design was followed wherein time intervals associated with 784 missions were analysed to document and describe response time interval, patient care interval and total mission times.

Results: On average crews took 0h 23:16 to respond to incidents before spending an additional 0h 43:20 treating and transporting their patients. Lengthy delays were noted between arrival at hospital and
crews booking available for the next call. This led to total mission times averaging 2h 11:00.

Conclusion: Average response and patient care time intervals noted in our study were longer than national and international norms and standards. Delays between arrival at hospital and crews booking available to service the next call led to average mission times of over 2 hours. This negatively impacts on availability of ambulances. Further studies are recommended to explore factors that may be contributing to the lengthy response and mission times reported in this study.