Simplifying Medical Priority Dispatch System Instructions - @

Simplifying Medical Priority Dispatch System Instructions

Street Science


Keith Wesley | | Tuesday, June 26, 2007

Review of: Dias JA, Brown TB, Saini RC, et al: "Simplified dispatch-assisted CPR instructions outperform standard protocol." Resuscitation. 72(1):108-114, 2007.

The Science

The 2005 AHA guidelines have impressed all of us with the importance of effective chest compressions. In the past, 9-1-1 emergency medical dispatchers (EMDs) were instructed to provide callers with instructions in providing CPR. Several studies have demonstrated how cumbersome and difficult it is to get the caller to perform both chest compression and mouth-to-mouth ventilations. Recent 9-1-1 protocols have advocated chest compression only instructions. This study examined the Medical Priority Dispatch System instructions with what the authors referred to as "simplified" instructions.

The primary difference between the two instruction sets is the degree of detail given to the caller, regarding where to place their hands and how deep to compress the chest. The simplified instructions state, "Pump the chest rapidly, in the center of the chest between the nipple, at a rate of about 100 per minute, as hard as you can. Keep doing this until the paramedics arrive. I ll stay on the line." These instructions took less than half the time to recite the MPDS instructions.

The researchers provided these instructions to volunteer callers who then performed chest compressions on a manikin, and the times and quality of compressions were measured. They found that the time to initiate CPR was significantly shorter with the simplified instructions. The simplified instructions also resulted in a greater proportion of chest compression depth.

The Street

I commend the authors for attempting to measure the effectiveness of pre-arrival advanced life support instructions. It is vital that we attempt to determine the best way to get 9-1-1 callers to provide quality CPR with minimal interruption and with instructions that are understandable and easy to follow.

The clear goal of pre-arrival ALS instructions is to get chest compressions started quickly and not stop until EMS arrives. While this study demonstrated that simplified instructions resulted in significantly improved chest compressions, there are some serious limitations to it.

The simulated callers were young, with an average age of about 25. The average cardiac arrest caller is significantly older. Following 9-1-1 CPR instructions without someone at the scene to help is physically difficult. The elderly caller is unlikely to be able to hold the phone to their ear and compress the chest, and therefore the instructions may need to be more detailed before chest compressions are begun.

While I agree that simplified instructions result in shorter time to chest compression, the next logical step is to perform this study using elderly callers. Another suggestion is to ask the caller if their phone has a speaker phone capability, which would allow the dispatcher to continue coaching the caller without interruption.

Connect: Have a thought or feedback about this? Add your comment now
Related Topics: Communications and Dispatch, Research

What's Your Take? Comment Now ...

Buyer's Guide Featured Companies

Featured Careers & Jobs in EMS

Get JEMS in Your Inbox


Fire EMS Blogs

Blogger Browser

Today's Featured Posts


EMS Airway Clinic

Improving Survival from Cardiac Arrest Using ACD-CPR + ITD

Using active compression-decompression CPR with an ITD has been shown to improve 1-year survival from cardiac arrest by 33%.
More >

Multimedia Thumb

Philadelphia Fire Department Apologizes for Medic’s Jab at Police

Union head calls photos a slap in the face of officers.
Watch It >

Multimedia Thumb

D.C. Fire and EMS Crews Blame New Technology for Patient’s Death

Delayed response blamed on recurring dispatch problems.
Watch It >

Multimedia Thumb

Suspect Steals, Crashes Maryland Ambulance

One killed, others injured in Prince George’s County crash.
Watch It >

Multimedia Thumb

Truck Strikes Pedestrians in Scotland

Six killed in downtown Glasgow.
More >

Multimedia Thumb

Tennessee Trench Rescue

Worker pulled from Roane County worksite.
More >

Multimedia Thumb

Time’s Ebola Firefighters

Doctors, nurses and others saluted for fighting virus.
More >

Multimedia Thumb

VividTrac offered by Vivid Medical - EMS Today 2013

VividTrac, affordable high performance video intubation device.
Watch It >

Multimedia Thumb

Braun Ambulances' EZ Door Forward

Helps to create a safer ambulance module.
Watch It >

Multimedia Thumb

The AmbuBus®, Bus Stretcher Conversion Kit - EMS Today 2013

AmbuBus®, Bus Stretcher all-hazards preparedness & response tool
Watch It >

More Product Videos >