PREHOSPITAL CARE

Does the use of the Advanced Medical Priority Dispatch System affect cardiac arrest detection?

A Heward, M Damiani, C Hartley-Sharpe

London Ambulance Service NHS Trust, London, UK

Correspondence to:
Correspondence to:
Mr A Heward
London Ambulance Service NHS Trust, 220 Waterloo Road, London SE1 8SD, UK; andy.heward{at}lond-amb.nhs.uk

Background: Cardiac arrest is the most widely recognised prehospital event that early intervention can directly affect. Chance of survival from this event decreases every minute that passes without treatment. To deliver a rapid ambulance response to these patients the early detection of cardiac arrest by control room staff is crucial. To achieve this, the London Ambulance Service (LAS) uses the Advanced Medical Priority Dispatch System. What impact has AMPDS had on identifying patients in cardiac arrest? Does compliance with AMPDS protocol influence the identification of patients in cardiac arrest?

Methods: A two stage study was undertaken. The first, compared cases coded as "cardiac arrest" and found by the responding ambulance to be in cardiac arrest before the implementation of AMPDS. This was compared with cases triaged as "cardiac arrest" and found to be in cardiac arrest across three years after AMPDS implementation. The second stage compared AMPDS compliance, over a 32 month period against the percentage of cardiac arrest calls that were found to be cardiac arrest upon the ambulance arrival. The correlation coefficient was calculated and analysed for statistical significance.

Findings: AMPDS resulted in a 200% rise in the number of patients accurately identified as suffering from cardiac arrest. A relation was identified between identification and AMPDS compliance (r² = 0.65, p = 0.001).

Discussion: The implementation of AMPDS increased accurate identification of patients in cardiac arrest. Additionally, the relation between factors identified suggests compliance with protocol is an important factor in the accurate recognition of patient conditions.

Keywords: emergency dispatch; cardiac arrest; call prioritisation

Abbreviations: AMPDS, Advanced Medical Priority Dispatch System; EMD, emergency medical dispatcher; LAS, London Ambulance Service; CQI, continuous quality improvement

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