Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-10T10:17:37.170Z Has data issue: false hasContentIssue false

The Accuracy of Emergency Medical Dispatcher-Assisted Layperson-Caller Pulse Check Using the Medical Priority Dispatch System Protocol

Published online by Cambridge University Press:  05 July 2012

Greg Scott*
Affiliation:
International Academies of Emergency Dispatch, Salt Lake City, Utah USA
Jeff Clawson
Affiliation:
International Academies of Emergency Dispatch, Salt Lake City, Utah USA
Mark Rector
Affiliation:
International Academies of Emergency Dispatch, Salt Lake City, Utah USA
Dave Massengale
Affiliation:
International Academies of Emergency Dispatch, Salt Lake City, Utah USA
Mike Thompson
Affiliation:
International Academies of Emergency Dispatch, Salt Lake City, Utah USA
Brett Patterson
Affiliation:
International Academies of Emergency Dispatch, Salt Lake City, Utah USA
Christopher H.O. Olola
Affiliation:
International Academies of Emergency Dispatch, Salt Lake City, Utah USA
*
Correspondence: Greg Scott, MBA International Academies of Emergency Dispatch 139 East South Temple, Suite 200 Salt Lake City, Utah 84111 USA E-mail greg.scott@emergencydispatch.org

Abstract

Introduction

Knowing the pulse rate of a patient in a medical emergency can help to determine patient acuity and the level of medical care required. Little evidence exists regarding the ability of a 911 layperson-caller to accurately determine a conscious patient's pulse rate.

Hypothesis

The hypothesis of this study was that, when instructed by a trained emergency medical dispatcher (EMD) using the scripted Medical Priority Dispatch System (MPDS) protocol Pulse Check Diagnostic Tool (PCDxT), a layperson-caller can detect a carotid pulse and accurately determine the pulse rate in a conscious person.

Methods

This non-randomized and non-controlled prospective study was conducted at three different public locations in the state of Utah (USA). A healthy, mock patient's pulse rate was obtained using an electrocardiogram (ECG) monitor. Layperson-callers, in turn, initiated a simulated 911 phone call to an EMD call-taker who provided instructions for determining the pulse rate of the patient. Layperson accuracy was assessed using correlations between the layperson-caller's finding and the ECG reading.

Results

Two hundred sixty-eight layperson-callers participated; 248 (92.5%) found the pulse of the mock patient. There was a high correlation between pulse rates obtained using the ECG monitor and those found by the layperson-callers, overall (94.6%, P < .001), and by site, gender, and age.

Conclusions

Layperson-callers, when provided with expert, scripted instructions by a trained 911 dispatcher over the phone, can accurately determine the pulse rate of a conscious and healthy person. Improvements to the 911 instructions may further increase layperson accuracy.

Scott G, Clawson J, Rector M, Massengale D, Thompson M, Patterson B, Olola CHO. The accuracy of emergency medical dispatcher-assisted layperson-caller pulse check using the Medical Priority Dispatch System protocol. Prehosp Disaster Med. 2012;27(3):1-8.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. National Academies of Emergency Dispatch. The National Academy QA v12 Guide, Medical Priority Dispatch System (MPDS): Protocol 19 (Heart Problems). Salt Lake City, Utah: Priority Dispatch Corp; 2008.Google Scholar
2. Bahr, J, Klingler, H, Panzer, W, Rode, H, Kettler, D. Skills of lay people in checking the carotid pulse. Resuscitation. 1997;35(1):23-26.CrossRefGoogle ScholarPubMed
3. Eberle, B, Dick, WF, Schneider, T, Wisser, G, Doetsch, S, Tzanova, I. Checking the carotid pulse check: diagnostic accuracy of first responders in patients with and without a pulse. Resuscitation. 1996;33(2):107-116.CrossRefGoogle ScholarPubMed
4. Walcott, GP, Melnick, SB, Walker, RG, et al. . Effect of timing and duration of a single chest compression pause on short-term survival following prolonged ventricular fibrillation. Resuscitation. 2009;80(4):458-462.CrossRefGoogle ScholarPubMed
5. Cummins, RO, Hazinski, MF. Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: International Consensus on Science. Circulation. 2000;102(8):I377-I379.Google Scholar
6. American Heart Association. Guidelines for cardiopulmonary resuscitation and emergency cardiac care. Emergency Cardiac Care Committee and Subcommittees, American Heart Association. Part II. Adult basic life support. J Am Med Assoc. 1992;268(1):2184-2198.Google Scholar
7. European Resuscitation Council. Guidelines for basic life support. A statement by the Basic Life Support Working Party of the European Resuscitation Council, 1992. Resuscitation. 1992;24(2):103-110.Google Scholar
8. Flesche, CW, Breuer, S, Mandel, LP, Breivik, H, Tarnow, J. The ability of health professionals to check the carotid pulse. Circulation. 1994;90:I288.Google Scholar