Abstract
Purpose
Early recognition of out-of-hospital cardiac arrest (OHCA) by 9-1-1 dispatchers is
a critical first step along the resuscitation pathway. Barriers to recognition may
lead to adverse outcomes among patients. This study aims to determine the impact of
seizure-like activity among OHCA patients during 9-1-1 calls.
Methods
We evaluated a retrospective cohort study of all adult, non-traumatic OHCAs that occurred
prior to emergency medical services (EMS) arrival on scene in a major metropolitan
area from 2014–2018. Dispatch recordings were reviewed to determine if seizure-like
activity was reported by the caller using key descriptor phrases such as “seizing,”
“shaking,” or “convulsing.” We compared patient demographics, arrest factors, and
hospital outcomes using a regional OHCA quality improvement database.
Results
Among 3502 OHCAs meeting our inclusion criteria, 149 (4.3%) contained seizure-like
activity. When compared to patients without seizure-like activity (3353; 95.7%), patients
presenting with seizure-like activity were younger (54 vs. 66 years old; p < 0.05),
had a witnessed arrest (88% vs 45%; p < 0.05), presented with an initial shockable
rhythm (52% vs. 24%; p < 0.05), and survived to hospital discharge (44% vs. 16%; p < 0.05).
The seizure-like activity group also had a longer median time to dispatcher identification
of the cardiac arrest [130 s (72,193) vs 62 s (43,102); p < 0.05].
Conclusions
Reported seizure-like activity among patients in cardiac arrest poses a barrier to
recognition of cardiac arrests by dispatchers leading to delays in resuscitation instructions.
Keywords
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Article info
Publication history
Published online: July 12, 2020
Accepted:
June 15,
2020
Received in revised form:
May 23,
2020
Received:
April 2,
2020
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
