Factors associated with the successful recognition of abnormal breathing and cardiac arrest by ambulance communications officers: a qualitative iterative survey.
Prehospital Emergency Care · 2012-01-01 · Qualitative study
Abstract
OBJECTIVES: We sought to identify barriers and facilitators to ambulance communications officers' (ACOs') recognition of abnormal breathing and administration of cardiopulmonary resuscitation (CPR) instructions. METHODS: We conducted semistructured qualitative interviews based on the constructs of the Theory of Planned Behavior to elicit salient attitudes, social influences, and behavioral controls potentially influencing ACOs' intent to recognize abnormal breathing as a symptom of cardiac arrest and administer CPR instructions over the phone. We conducted interviews until achieving data saturation. We recorded interviews and transcribed them verbatim. Two independent reviewers performed inductive analyses to identify emerging themes. RESULTS: We interviewed 24 ACOs from four Canadian provinces (67% female, median 9.5 years of experience, 33% with paramedic training). We identified eight behavioral, 14 subjective normative, and 22 control beliefs. Important attitudes were as follows: 1) CPR instructions may help the patient and are likely to be beneficial for the caller; 2) abnormal breathing is an early sign of cardiac arrest; and 3) dispatch-assisted CPR instructions can improve survival. The leading social influence was management/quality assurance staff. Behavioral control was the construct most associated with ACOs' ability to recognize abnormal breathing, including 1) adherence to mandatory scripted protocol, 2) poor caller description of breathing pattern, and 3) ACO training on abnormal breathing. CONCLUSIONS: This qualitative study found that control beliefs are most influential on ACOs' intention to recognize abnormal breathing and provide CPR instructions over the phone. Training and policy changes should target these beliefs to increase the frequency of ACO-administered CPR instructions to callers reporting a patient in cardiac arrest.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Communication & handover · Dispatchers & call takers · Implementation
Related articles
- Evaluation of emergency medical dispatch in out-of-hospital cardiac arrest in Taipei. (Resuscitation, 2007)
- Emotion displays in ambulance calls for out-of-hospital cardiac arrest: A qualitative inquiry of caller and call-taker communication. (Australas Emerg Care, 2026)
- Barriers for Responding to Pediatric Out-of-Hospital Cardiac Arrest During Emergency Medical Calls: A Qualitative Study. (J Am Heart Assoc, 2025)
- A mixed methods analysis of caller-emergency medical dispatcher communication during 9-1-1 calls for out-of-hospital cardiac arrest. (Patient Educ Couns, 2022)
- The linguistic and interactional factors impacting recognition and dispatch in emergency calls for out-of-hospital cardiac arrest: a mixed-method linguistic analysis study protocol. (BMJ Open, 2017)
- Targeted simulation and education to improve cardiac arrest recognition and telephone assisted CPR in an emergency medical communication centre. (Resuscitation, 2017)