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The following is a summary of “Understanding cardiac arrest dispatch of physician-paramedic critical care prehospital teams: a survey-based evaluation,” published in the February 2025 issue of Emergency Medicine by Morton et al.
Ensuring that critical care teams are properly dispatched to out-of-hospital cardiac arrest (OHCA) cases has been recognized as a key research priority in emergency care within the UK.
Researchers conducted a retrospective study to explore the criteria used to decide when to dispatch a critical care physician-paramedic team to OHCA in 1 UK region.
They invited clinicians and non-clinicians from the East of England Ambulance Service NHS Trust critical care (physician-paramedic) dispatch desk to participate in an anonymized online survey via email between June and July 2023. Demographic data on dispatcher experience were collected, with assessments of 15 predetermined criteria (from a pilot survey) influencing OHCA dispatch decisions. Responses to closed-ended questions were analyzed as percentages. A mandatory free-text question on physician-paramedic dispatch was included, with 1 author interpreting the responses and all authors reviewing the interpretation.
The results showed 20 respondents (19 critical care paramedics and 1 non-clinical dispatcher) participated, with a response rate of 79% for clinical and 17% for non-clinical dispatchers. ‘Witnessed cardiac arrest’ and return of spontaneous circulation secured on scene were considered by 100% of respondents when dispatching a physician-paramedic team to OHCA. At least 75% of respondents found 10 out of 15 predetermined criteria important in decision-making. ‘Age’ was viewed beyond just a number, factoring in the complexities of cardiac arrest and the role of physiological reserve and frailty.
Investigators concluded that while “witnessed arrest” was the sole universally agreed-upon dispatch criterion, variations existed, and additional information, such as frailty identification, was gathered to inform nuanced decision-making.
Source: emj.bmj.com/content/early/2025/02/05/emermed-2024-214178
