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Observational Study
. 2016 Apr 22:24:53.
doi: 10.1186/s13049-016-0247-y.

Impact of an emergency medical dispatch system on survival from out-of-hospital cardiac arrest: a population-based study

François-Xavier Ageron  1   2 , Guillaume Debaty  3 , Angèle Gayet-Ageron  4 , Loïc Belle  5   6 , Arnaud Gaillard  7 , Marie-France Monnet  8 , Stéphane Bare  9 , Jean-Christophe Richard  10 , Vincent Danel  3 , Jean-Pierre Perfus  10 , Dominique Savary  10
Affiliations
Observational Study

Impact of an emergency medical dispatch system on survival from out-of-hospital cardiac arrest: a population-based study

François-Xavier Ageron et al. Scand J Trauma Resusc Emerg Med. .

Abstract

Background: In countries where a single public emergency telephone number is not in operation, different emergency telephone numbers corresponding to multiple dispatch centres (police, fire, emergency medical service) may create confusion for the population about the most appropriate service to call. In particular, out-of-hospital cardiac arrest (OHCA) requires a prompt and effective response. We compare two different dispatch systems on OHCA patient survival at 30 days in a national system with multiple emergency telephone numbers.

Methods: We conducted an observational retrospective study of 6871 patients aged 18 years or older with presumed OHCA of cardiac origin between 2005 and 2013 in three counties of the Northern French Alps region. One county had a single dispatch centre combining medical and fire emergencies, and two had multiple dispatch centres. Propensity score matching analyses were performed to compare patient survival at 30 days.

Results: A total of 2257 emergency calls for OHCA were managed by a single dispatch centre and 4614 by a multiple dispatch centre. A single dispatch centre was associated with an increase in survival (adjusted odds ratio [OR] for all patients: 1.7; 95 % confidence interval [CI] = 1.3-2.2; p <0.001; adjusted OR for propensity-matched patients: 2.0; 95 % CI = 1.2-3.4; p = 0.012).

Conclusions: A single dispatch centre was associated with a markedly improved increase of survival among OHCA patients at 30 days in a system with several emergency telephone numbers.

Keywords: Cardiopulmonary resuscitation; Dispatch centre; Emergency phone number; Out-of-hospital cardiac arrest; Survival.

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Figures

Fig. 1
Fig. 1
Emergency medical service system in the Northern French Alps Emergency Network. In the area with the single dispatch centre system, there are 92 BLS ambulances in 89 rescue centres for a population of 782,900 inhabitants in 4388 km2. In the area with the multiple dispatch centre system, there are 216 BLS ambulances in 208 rescue centres for a population of 1,556,600 inhabitants in 13,459 km2. The number of ambulances per inhabitant : 11.8 ambulances/100.000 inhabitants in the single dispatch centre system and 13.9 ambulances/100.000 inhabitants in the multiple dispatch centre system. BLS ambulance are evenly distributed to cover the entire area with a maximum on-site time of 20 min.BLS: basic life support; FD: fire department; EMS: emergency medical service
Fig. 2
Fig. 2
Pathway of emergency calls for out-of-hospital cardiac arrest depending on the dispatch centre system in the Northern French Alps. FD: fire department; EMS: emergency medical service; BLS: basic life support; ALS: Advanced life support
Fig. 3
Fig. 3
Study flow chart based on the Northern French Alps Cardiac Arrest Registry, 2005–2013
See this image and copyright information in PMC

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