Resuscitation
Volume 75, Issue 2 , Pages 298-304, November 2007

Cardiac arrest predictability in seizure patients based on emergency medical dispatcher identification of previous seizure or epilepsy history☆

  • Jeff Clawson

      Affiliations

    • International Academies of Emergency Dispatch, Salt Lake City, Utah 84111, USA
    • Corresponding Author InformationCorresponding author. International Academies of Emergency Dispatch, 139 East South Temple, Suite 200, Salt Lake City, Utah 84111, USA. Tel.: +1 801 363 9127; fax: +1 801 363 9173.
    • ,
  • Christopher Olola

      Affiliations

    • International Academies of Emergency Dispatch, Salt Lake City, Utah 84111, USA
    • ,
  • Andy Heward

      Affiliations

    • London Ambulance Service NHS Trust, London, UK
    • ,
  • Brett Patterson

      Affiliations

    • International Academies of Emergency Dispatch (IAED), Florida, USA

Received 26 January 2007; received in revised form 28 April 2007; accepted 30 April 2007. published online 09 July 2007.

Summary 

Objective

To determine predictability of at-scene cardiac arrest from a dispatch determined patient history of seizure or epilepsy (“E” history).

Design and methods

A retrospective study of a 1 year dataset from the London Ambulance Service (LAS) National Health Service (NHS) Trust was undertaken. Each of the nine determinant codes on the Medical Priority Dispatch System (MPDS®) seizure protocol [Heward A, Damiani M, Hartley-Sharpe C. Does the use of the Advanced Medical Priority Dispatch System affect cardiac arrest detection? Emerg Med J 2004;21:115–8.] was examined for the addition of the “E” suffix finding. The cardiac arrest predictability of cases with reported “E” history was compared to those without using a protocol process to detect the infrequent but predictable presence of seizures caused by anoxic cardiac arrest.

Results

Only protocol codes 12-A-1, 12-D-2, 12-D-3, and 12-D-4 demonstrated significant associations between outcomes and determinant codes (p=0.016, 0.007, <0.001, and 0.048, respectively). These codes showed reduced risk of predicting CA with the “E” suffix protocol determinant codes (RD (95% CI): −0.0025 (−0.0044, −0.0005), chi-square p=0.009; RD (95% CI): −0.0024 (−0.0042, −0.0005), p=0.005; RD (95% CI): −0.020 (−0.029, −0.011), p<0.001; RD (95% CI): −0.01 (−0.017, −0.005), and p=0.034, respectively).

Conclusions

Knowing whether a seizure patient is an epileptic or has had previous seizures is of clinical value and relevant to dispatch. By improving the discernment of the seizure protocol regarding seizure associated with anoxic cardiac arrest predictability, this information may now be applied at the response level as well as to emergency medical dispatcher's (EMD) decisions to stay on the telephone to enhance the monitoring of these patients.

Keywords: Cardiac arrest, Anoxic seizures, Anoxic fits, Clonic seizures, Emergency medical dispatch, Agonal, Pre-hospital instructions, Dispatch outcome, History of seizures, Epilepsy, Respiration disorders

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

☆ A Spanish translated version of the summary of this article appears as Appendix in the final online version at 10.1016/j.resuscitation.2007.04.029.

PII: S0300-9572(07)00248-1

doi:10.1016/j.resuscitation.2007.04.029

Resuscitation
Volume 75, Issue 2 , Pages 298-304, November 2007

Article Tools