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Time delays to reach dispatch centres in different regions in Europe. Are we losing the window of opportunity? - The EUROCALL study

N. Nikolaou, M. Castrén, KG. Monsieurs, D. Cimpoesu, M. Georgiou, V. Raffay, R. Koster, S. Hunyadi-Antičević, A. Truhlář, L. Bossaert, . ,

. 2017 ; 111 (-) : 8-13. [pub] 20161114

Language English Country Ireland

Document type Journal Article, Multicenter Study, Randomized Controlled Trial

Persistent link   https://www.medvik.cz/link/bmc18010940

AIM: In out of hospital cardiac arrest (OHCA) the start of Cardiopulmonary Resuscitation (CPR) by a single rescuer may be delayed considerably if the total time (TT) to connect the telephone call to the Emergency Medical Communication Centre (EMCC) is prolonged. EUROCALL investigated the TT-EMCC and its components using different calling procedures. METHODS: This prospective, multicentre, randomised study was performed in April 2013. Telephone calls were randomly allocated to time of call, and to those connecting directly to the EMCC (1-step procedure) and those diverted before connecting to the EMCC (2-step procedure). RESULTS: Twenty-one EMCCs from 11 countries participated in the study. Time to first ringtone was similar between 1-step 3.7s (IQR 1.0-5.2) and 2-step calls 4.0s (IQR 2.4-5.2). For the 1878 1-step calls, the median TT-EMCC was 11.7s (IQR 8.7-18.5). For the 1550 2-step calls, the median time from first ringtone to first call-taker was 7s (IQR 4.6-11.9) and from first call-taker to EMCC was 18.7s (IQR 13.4-29.9). Median TT-EMCC was 33.2 s (IQR 24.7-46.1) and was significantly longer than the TT-EMCC observed with the 1-step procedure (P<0.0001). Significant differences existed among participating regions between and within different countries both for 1-step and 2-step procedures. CONCLUSION: TT-EMCC was significantly shorter in a 1-step procedure compared to a 2-step procedure. Regional differences existed between countries but also within countries. This may be relevant in cases of OHCA and other situations where patient outcome is critically time-dependent.

References provided by Crossref.org

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$a AIM: In out of hospital cardiac arrest (OHCA) the start of Cardiopulmonary Resuscitation (CPR) by a single rescuer may be delayed considerably if the total time (TT) to connect the telephone call to the Emergency Medical Communication Centre (EMCC) is prolonged. EUROCALL investigated the TT-EMCC and its components using different calling procedures. METHODS: This prospective, multicentre, randomised study was performed in April 2013. Telephone calls were randomly allocated to time of call, and to those connecting directly to the EMCC (1-step procedure) and those diverted before connecting to the EMCC (2-step procedure). RESULTS: Twenty-one EMCCs from 11 countries participated in the study. Time to first ringtone was similar between 1-step 3.7s (IQR 1.0-5.2) and 2-step calls 4.0s (IQR 2.4-5.2). For the 1878 1-step calls, the median TT-EMCC was 11.7s (IQR 8.7-18.5). For the 1550 2-step calls, the median time from first ringtone to first call-taker was 7s (IQR 4.6-11.9) and from first call-taker to EMCC was 18.7s (IQR 13.4-29.9). Median TT-EMCC was 33.2 s (IQR 24.7-46.1) and was significantly longer than the TT-EMCC observed with the 1-step procedure (P<0.0001). Significant differences existed among participating regions between and within different countries both for 1-step and 2-step procedures. CONCLUSION: TT-EMCC was significantly shorter in a 1-step procedure compared to a 2-step procedure. Regional differences existed between countries but also within countries. This may be relevant in cases of OHCA and other situations where patient outcome is critically time-dependent.
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$a Castrén, Maaret $u Dept. of Emergency Medicine and Services, Helsinki University Hospital and Helsinki University, Helsinki, Finland.
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$a Raffay, Violetta $u Municipal Institute for Emergency Medicine, Novi Sad, Serbia; Serbian Resuscitation Council, Novi Sad, Serbia.
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$a Hunyadi-Antičević, Silvija $u Center for Emergency Medicine, Clinical Hospital Center Zagreb, Zagreb, Croatia.
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