A better survival is associated with the use of a single dispatch center in out-of-hospital cardiac arrests, results from the cardiac arrest cohort in the Northern French Alps emergency network

Introduction: When “public-safety-answering-point” as 9-1-1 is not provided, worldwide people could reach different emergency phone number corresponding to multiple dispatch center (MDC) for each service: Police, fire department (FD) or emergency medical service (EMS). In case of out-of-hospital cardiac arrest (OHCA), it could be confusing for the population which one is the most appropriate to call. Our objective was to assess the predictors of survival and in particular to evaluate the association between mortality and the use of a single dispatch center (SDC) combined EMS and FD compared to MDC. Methods: We used data from a prospective cohort of OHCA recorded in a multicentre registry from 3 department of the Northern French Alps, among those 1 had a SDC and 2 had a MDC. We included all patients >18 years old in whom resuscitation was attempted and cardiac aetiology presumed. OHCA witnessed by EMS personnel were excluded. The primary end point was the mortality rate at hospital discharge. Logistic regression was used to assess the predictors of death. Results: Between 2005 and 2009, 9051 OHCA were recorded in the registry among which 3204 fulfilled the inclusion criteria. 143 were discharged alive (4.4%). In the multivariate model, the following covariables were independently and significantly associated with a higher death at hospital discharge: age > 70 years (odds ratio [OR] 2.22; 95%CI: 1.34–3.68), OHCA occurrence at home (OR 3.09; 95%CI: 2.11–4.53), call-response delay >10 min (OR 1.62; 95%CI: 1.04–2.53), first call to FD (OR 1.75; 95%CI: 1.20–2.55). The following covariates were independently associated with a decrease of mortality: shockable rhythm (OR 0.10; 95%CI: 0.06–0.16), bystander witnessed (OR 0.40; 95%CI: 0.20–0.78), SDC (OR 0.68; 95%CI: 0.46–0.99). Conclusion: When single emergency phone number is not provided, SDC is effective to reduce mortality in OHCA. EMS system with medically trained dispatcher is associated with a reducing mortality, probably explained by an earlier recognition of OHCA.1Berdowski J. Beekhuis F. Zwinderman A.H. Tijssen J.G. Koster R.W. Importance of the first link: description and recognition of an out-of-hospital Cardiac Arrest in an Emergency Call.Circulation. 2009; 119: 2096-2102Crossref PubMed Scopus (173) Google Scholar