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Early CPR and defibrillation by laypersons in out-of-hospital ardiac arrest: process evaluation from a perspective of EMS personnel in the region of Twente NL

Huisman, H.M. (2010) Early CPR and defibrillation by laypersons in out-of-hospital ardiac arrest: process evaluation from a perspective of EMS personnel in the region of Twente NL.

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Abstract:Aim: The goal of this study was to evaluate the process of a project whereby laypersons provide early emergency medical care and assistance in out-of-hospital cardiac arrest from the perspective of EMS personnel in order to identify problems and possible improvements. - Methods: In March 2008 the EMS Ambulance Oost [NL] implemented an alert system with at this moment approximately 6000 volunteers. After dispatching two ambulances to a suspected cardiac arrest, the system alerts all volunteers in a radius of 1000 meters of the victim to provide early CPR and early defibrillation. After arriving of EMS personnel a cooperation with laypersons could follow. A paper-based questionnaire was send to the home address of 149 employees of the EMS; 82 specialized nurses and 67 drivers of which 27 were instructor external education. The questionnaire focused on the experiences of EMS personnel with laypersons on site concerning the following aspects: number of laypersons on site, quality of layperson’s skills concerning CPR and use of AED, communication between EMS personnel and laypersons and within the organization and general opinion of the project. - Results: The response in this study was 38,9%; 58,6% were specialized nurses and 41,4% were drivers, 22,4% of these specialized nurses and drivers were also instructors external education. EMS personnel graded the project on a scale from 1 to 10 with a 7,7. More than half of the EMS personnel mentioned that sometimes or mostly there were either too many (70,6%) or no (68.4%) laypersons on site and a majority (75,9%) experienced 5 to 8 laypersons on site as too many. Quality of laypersons’ skills concerning CPR and use of AED by laypersons was according to the opinion of EMS personnel in general good. With respect to the aspect communication between EMS personnel and laypersons, laypersons were respectful, friendly, accepted EMS personnel authority and were easily corrected. Information that EMS personnel needed was communicated by laypersons or could be gathered easily by asking specific questions. After the resuscitation, EMS personnel could provide aftercare. The most common way of providing aftercare was expressing gratitude to laypersons. About half of the EMS personnel said that they never told laypersons about the special website or gave a business card in order to provide aftercare in a later stage. The dispatch center of the EMS did not always notify whether laypersons were alerted to EMS personnel, but this was desired by 83,9% of the EMS personnel. A majority of EMS personnel (61,9%) also desired recognizability of laypersons on site. Most often problems relating to technical procedures concerning the resuscitation by laypersons (47,4%) and problems relating to aftercare (43,9%) were experienced by EMS personnel, but only a minority communicated these problems within the EMS. - Conclusions: Overall EMS personnel were positive about laypersons who provided or assisted in emergency medical care for victims with out-of-hospital cardiac arrest. Improvements could be made on the following aspects: number of laypersons on site, communication between EMS personnel and laypersons on site, aftercare for laypersons provided by EMS personnel and communication within the EMS. Therefore can be recommended a leaflet for laypersons with clear information about a maximum of laypersons on site, how to act on site and to communicate with EMS personnel. Also agreements, communicated to EMS personnel by the EMS, can be recommended about providing aftercare, notification of alarming laypersons by the dispatch center and recognizability of laypersons on site. Also EMS personnel should be encouraged to communicate experienced problems with laypersons on site. These recommendations could lead to a better cooperation and a better way of providing care, which could lead to a higher survival of out-of-hospital cardiac arrest victims.
Item Type:Essay (Master)
Clients:
Ambulance Oost, Hengelo, Netherlands
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:85 business administration, organizational science
Programme:Health Sciences MSc (66851)
Keywords:Cardiopulmonary resuscitation (CPR), Automated external defibrillator (AED), Defibrillation, Emergency medical services (EMS), Out-of-hospital cardiac arrest (OOH-CA), Laypersons, Text message alert
Link to this item:http://purl.utwente.nl/essays/60617
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