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dc.contributor.authorFukushima, Hidetada
dc.contributor.authorPanczyk, Micah
dc.contributor.authorHu, Chengcheng
dc.contributor.authorDameff, Christian
dc.contributor.authorChikani, Vatsal
dc.contributor.authorVadeboncoeur, Tyler
dc.contributor.authorSpaite, Daniel W.
dc.contributor.authorBobrow, Bentley J.
dc.date.accessioned2017-11-06T23:30:49Z
dc.date.available2017-11-06T23:30:49Z
dc.date.issued2017-08-29
dc.identifier.citationDescription of Abnormal Breathing Is Associated With Improved Outcomes and Delayed Telephone Cardiopulmonary Resuscitation Instructions 2017, 6 (9):e005058 Journal of the American Heart Associationen
dc.identifier.issn2047-9980
dc.identifier.issn2047-9980
dc.identifier.doi10.1161/JAHA.116.005058
dc.identifier.urihttp://hdl.handle.net/10150/626000
dc.description.abstractBackground-Emergency 9-1-1 callers use a wide range of terms to describe abnormal breathing in persons with out-of-hospital cardiac arrest (OHCA). These breathing descriptors can obstruct the telephone cardiopulmonary resuscitation (CPR) process. Methods and Results-We conducted an observational study of emergency call audio recordings linked to confirmed OHCAs in a statewide Utstein-style database. Breathing descriptors fell into 1 of 8 groups (eg, gasping, snoring). We divided the study population into groups with and without descriptors for abnormal breathing to investigate the impact of these descriptors on patient outcomes and telephone CPR process. Callers used descriptors in 459 of 2411 cases (19.0%) between October 1, 2010, and December 31, 2014. Survival outcome was better when the caller used a breathing descriptor (19.6% versus 8.8%, P<0.0001), with an odds ratio of 1.63 (95% confidence interval, 1.17-2.25). After exclusions, 379 of 459 cases were eligible for process analysis. When callers described abnormal breathing, the rates of telecommunicator OHCA recognition, CPR instruction, and telephone CPR were lower than when callers did not use a breathing descriptor (79.7% versus 93.0%, P<0.0001; 65.4% versus 72.5%, P=0.0078; and 60.2% versus 66.9%, P=0.0123, respectively). The time interval between call receipt and OHCA recognition was longer when the caller used a breathing descriptor (118.5 versus 73.5 seconds, P<0.0001). Conclusions-Descriptors of abnormal breathing are associated with improved outcomes but also with delays in the identification of OHCA. Familiarizing telecommunicators with these descriptors may improve the telephone CPR process including OHCA recognition for patients with increased probability of survival.
dc.description.sponsorshipMedtronic Foundation through the HeartRescue Granten
dc.language.isoenen
dc.publisherWILEYen
dc.relation.urlhttp://jaha.ahajournals.org/lookup/doi/10.1161/JAHA.116.005058en
dc.rights© 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License.en
dc.subjectcardiac arresten
dc.subjectcardiopulmonary resuscitationen
dc.subjecttelecommunicationsen
dc.titleDescription of Abnormal Breathing Is Associated With Improved Outcomes and Delayed Telephone Cardiopulmonary Resuscitation Instructionsen
dc.typeArticleen
dc.contributor.departmentUniv Arizona, Coll Med, Arizona Emergency Med Res Ctren
dc.contributor.departmentUniv Arizona, Coll Med, Dept Emergency Meden
dc.contributor.departmentUniv Arizona, Mel & Enid Zuckerman Coll Publ Hlth, Dept Epidemiol & Biostaten
dc.identifier.journalJournal of the American Heart Associationen
dc.description.noteOpen Access Journal; Creative Commons Attribution Non-Commercial License.en
dc.description.collectioninformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.en
dc.eprint.versionFinal published versionen
refterms.dateFOA2018-09-11T23:57:11Z
html.description.abstractBackground-Emergency 9-1-1 callers use a wide range of terms to describe abnormal breathing in persons with out-of-hospital cardiac arrest (OHCA). These breathing descriptors can obstruct the telephone cardiopulmonary resuscitation (CPR) process. Methods and Results-We conducted an observational study of emergency call audio recordings linked to confirmed OHCAs in a statewide Utstein-style database. Breathing descriptors fell into 1 of 8 groups (eg, gasping, snoring). We divided the study population into groups with and without descriptors for abnormal breathing to investigate the impact of these descriptors on patient outcomes and telephone CPR process. Callers used descriptors in 459 of 2411 cases (19.0%) between October 1, 2010, and December 31, 2014. Survival outcome was better when the caller used a breathing descriptor (19.6% versus 8.8%, P<0.0001), with an odds ratio of 1.63 (95% confidence interval, 1.17-2.25). After exclusions, 379 of 459 cases were eligible for process analysis. When callers described abnormal breathing, the rates of telecommunicator OHCA recognition, CPR instruction, and telephone CPR were lower than when callers did not use a breathing descriptor (79.7% versus 93.0%, P<0.0001; 65.4% versus 72.5%, P=0.0078; and 60.2% versus 66.9%, P=0.0123, respectively). The time interval between call receipt and OHCA recognition was longer when the caller used a breathing descriptor (118.5 versus 73.5 seconds, P<0.0001). Conclusions-Descriptors of abnormal breathing are associated with improved outcomes but also with delays in the identification of OHCA. Familiarizing telecommunicators with these descriptors may improve the telephone CPR process including OHCA recognition for patients with increased probability of survival.


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