Stress and distress: the art and science of dispatcher’s assisted cardiopulmonary resuscitation.
Abstract
Chances of survival following a cardiac arrest are very low and inversely proportional to the duration of cardiovascular arrest. It is of critical importance to perform cardiopulmonary resuscitation (CPR) as soon as possible, even before the arrival of emergency medical team (EMT) on the scene. Therefore, early bystander CPR is a key factor in improving survival from out-of-hospital cardiac arrest (OOH-CA). In Belgium, the ALERT algorithm (Algorithme Liégeois d’Encadrement à la Réanimation par Téléphone[1] offers the opportunity to help bystanders perform CPR. Dispatchers’ assisted telephone CPR has introduced a new link in the chain of survival, that contributes to a reduced OOH-CA mortality rate but at the cost of increased responsibilities and stress. ALERT also gives a new role to bystanders; they are no longer just spectators but become actors when they witness a cardiac arrest. Our team was interested in the psychological burden of ALERT. Therefore, we evaluated the effects of CPR performed by untrained persons. We studied the potential influence of different coping strategies on this impact, as well as the possible correlation with the degree of attachment to the victim and the risk of developing PTSD (Post Traumatic Stress Disorder). We noticed that some psychological negative impact on the bystanders could be recognized. We also identified beneficial and detrimental coping strategies. In the future, we wonder if Video-CPR (V-CPR) might improve the quality of resuscitation.
[1] Algorithm for CPR guidance over the phone originating from Liege, Belgium
Keywords
Full Text:
PDFReferences
Ahern R.M., Lozano R., Naghavi M., Foreman K., Gakidou E., Murray C.J. Improving the public utility of global cardiovascular mortality data: the rise of ischemic heart disease. Population Health Metrics. 2011; 15;9:8.
Lloyd-Jones D., Adams R., Carnethon M., De Simone G., Ferguson T.B., Flegal K., Ford E., Furie K., Go A., Greenlund K., Haase N., Hailpern S., Ho M., Howard V., Kissela B., Kittner S., Lackland D., Lisabeth L., Marelli A., McDermott M., Meigs J., Mozaffarian D., Nichol G., O'Donnell C., Roger V., Rosamond W., Sacco R., Sorlie P., Stafford R., Steinberger J., Thom T., Wasserthiel-Smoller S., Wong N., Wylie-Rosett J., Hong Y. Heart disease and stroke statistics – 2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009; 119: 480–486.
Ornato, J.P. Science of emergency medical dispatch. Circulation. 2009; 119, 2023-2025.
Wachelder, E.M., Moulaert, V.R., van Heugten, C., Verbunt, J.A., Bekkers, S.C., Wade, D.T. Life after survival: long-term daily functioning and quality of life after an out-of-hospital cardiac arrest. Resuscitation. 2009; 80, 517-522.
Nolan, J.P. European resuscitation council guidelines for resuscitation 2010 Section 1. Executive summary. Resuscitation. 2010; 81, 1219-1276.
Larsen, M.P., Eisenberg, M.S., Cummins, R.O., Hallstrom, A.P. Predicting survival from out-of-hospital cardiac arrest: A graphic model. Annals of Emergency Medicine. 1993; 22, 1652-1658.
Cummins, R.O., Eisenberg, M.S. Cardiopulmonary resuscitation- American style. British Medical Journal. 1985; 291, 1401-1403.
Cummins, R.O., Ornato, J.P., Thies, W.H, Pepe, P.E., Billi, J.E., Seidel, J;, Jaffe, A.S., Goldstein, S., Abramson, N.S., Brown, C., Chandra, N.C., Gonzalez, E.R., Newel, L., Stults, K.R., Membrino, G.E.. Improving survival from sudden cardiac arrest: the "chain of survival" concept. A statement for health professionals from the advanced cardiac life support subcomittee, American Heart Association. Circulation. 1991; 83, 1832-1847.
Stipulante, S, Tubes, R., El Fassi, M., Donneau, A.F., Vantroyen, B., Hartstein, G., D’Orio, V., Ghuysen, A. Implementation of the ALERT algorithm, a new dispatcher-assisted telephone cardiopulmonary resuscitation protocol, in non-Advanced Medical Priority Dispatch System (AMPDS) Emergency Services Centers. Resuscitation. 2014; 85, 177-181.
Van Alem, A.P., Vrenken, R.H., De Vos, R., Tijssen, J.G., Koster, R.W. Use of automated external defibrillator by first responders in out of hospital cardiac arrest: Prospective controlled trial. British Medical Journal. 2003; 327, 1312-1315.
Stiell, I.G., Wells, G.A., Field, B.J., Spaite, D.W., De Maio, V.J., Ward, R., Munkley, D.P., Lyver, M.B., Luinstra, L.G., Campeau, T., Maloney, J., Dagnone, E. Improved out-of-hospital cardiac arrest survival through the inexpensive optimization of an existing defibrillation program: OPALS study phase II. Ontario Prehospital Advanced Life Support. JAMA. 1999; Apri 7; 281 (13): 175-81.
Jackson, J.R., Nolan, J.P. Improving outcome in out-of-hospital cardiac arrest: impact of bystander cardiopulmonary resuscitation and prehospital physician care. Critical Care. 2011; 15 (1): 101.
Clawson, JJ, Dernocoeur, KB. Principles of Emergency Medical Dispatch. Englewood Cliffs, N.J.: Prentice Hall, 1988.
Ghuysen, A., Collas, D., Stipulante, S., Donneau, A.F., Hartstein, G., Hosmans, T., Vantroyen, B., D’Orio, V. Dispatcher-assisted telephone cardiopulmonary resuscitation using a French-language compression-only protocol in volunteers with or without prior life support training: à randomized trial. Resuscitation. 2011; 82, 57-63.
Ghuysen, A., El Fassi, M., Stipulante, S., D’Orio, V. Belgian dispatchers' telephone cardiopulmonary resuscitation protocol training: an evaluation study. Critical Care. 2011; 15, 289.
Stipulante, S., Hansenne, Y., El Fassi, M., Zandona, R., Donneau, A.F., D’Orio, V., Guysen, A. ALERT-protocol: efficiency of an e-learning training in non-Advanced Medical Priority Dispatch System (AMPDS) Emergency Medical Services centres. Resuscitation. 2013; 84, S47.
Jabre, P., Belpomme, V., Azoulay, E., Jacob, L., Bertrand, L., Lapostolle, F., Tazarourte, K., Bouilleau, G., Pinaud, V., Broche, C., Normand, D., Baubet, T., Ricard-Hibon, A., Istria, J., Beltramini, A., Alheritiere, A., Assez, N., Nace, L., Vivien, B., Turi, L., Launay, S., Desmaizieres, M., Borron, S. W., Vicaut, E., & Adnet, F.. Family presence during cardiopulmonary resuscitation. The New England Journal of Medicine. 2013; 368, 1008-1018.
Goldberg, D., Mcdowell, I. & Newell, C. 1972. General Health Questionnaire (GHQ), 12 item version, 20 item version, 30 item version, 60 item version [GHQ12, GHQ20, GHQ30, GHQ60]. Measuring health: A guide to rating scales and questionnaire, 225-36.
Meyer, T. J., Miller, M. L., Metzger, R. L. & Borkovec, T. D. 1990. Development and validation of the Penn State worry questionnaire. Behaviour research and therapy, 28, 487-495.
Brunet, A., Weiss, D. S., Metzler, T. J., Best, S. R., Neylan, T. C., Rogers, C., Fagan, J. & Marmar, C. R. 2001. The Peritraumatic Distress Inventory: a proposed measure of PTSD criterion A2. American Journal of Psychiatry, 158, 1480-1485.
Weathers, F., Litz, B., Herman, D., Huska, J. & Keane, T. 1993. The PTSD Checklist (PCL): Reliability, validity and diagnostic utility. Paper presented at the Annual Convention of the International Society for Stress Studies.
Cousson, F., Bruchon-Schweitzer, M., Quintard, B., Nuissier, J. & Rascle, N. 1996. Analyse multidimensionnelle d'une échelle de coping: validation française de la WCC (Ways of Coping Checklist). Psychologie française, 41, 155-164.
Pomini, V. 1997. Autocontrôle et réhabilitation psychiatrique: perspectives théoriques et empiriques, Université de Lausanne.
Joseph, S., Williams, R. & Yule, W. 1992. Crisis support, attributional style, coping style, and post-traumatic symptoms. Personality and Individual Differences, 13, 1249-1251.
Langevin, V., François, M., Boini, S. & Riou, A. 2011. Les questionnaires dans la démarche de prévention du stress au travail. Documents pour le médecin du travail, 125, 23-36.
Gosselin, P., Dugas, M., Ladouceur, R. & Freeston, M. 2001. Évaluation des inquiétudes: validation d’une traduction française du Penn State Worry Questionnaire. L’encéphale, 27, 475-484.
Jehel, L., Brunet, A., Paterniti, S. & Guelfi, J. D. 2005. Validation de la version française de l'inventaire de détresse péritraumatique. Canadian journal of psychiatry, 50, 67.
Blanchard, E. B., Jones-Alexander, J., Buckley, T. C. & Forneris, C. A. 1996. Psychometric properties of the PTSD checklist (PCL). Behaviour research and therapy, 34, 669-673.
Gerin, W., Milner, D., Chawla, S., & Picketing, T. G.. Social support as a moderator of cardiovascular reactivity in women: A test of the direct effects and buffering hypotheses. Psychosomatic Medicine. 1995; 57, 16-22.
Hunziker, S., Pagani, S., Fasler, K., Tschan, F., Semmer, N. K., & Marsch, S. Impact of a stress coping strategy on perceived stress levels and performance during a simulated cardiopulmonary resuscitation: A randomized controlled trial. BMC Emergency Medicine. 2013; 13, 8.
Adams, R.E., & Boscarino, J.A.. Predictors of psd and delayed ptsd after disaster the impact of exposure and psychological resources. Journal of Nervous and Mental Disease. 2006; 194, 485-493.
Guelfi, J.-D. (2004). DSM-4-TR: Elsevier Masson.
Dosanjh, S., Barnes, J., & Bhandari, M.. Barriers to breaking bad news among medical and surgical residents. Medical Education. 2001; 35, 197–205.
Stipulante, S., Delfosse, A.S., Donneau, A.F., Hartstein, G., Haus, S., D’Orio V., Guysen, A. Interactive videoconferencing versus audio phone calls for dispatcher-assisted cerdiopulmonary resuscitation using the ALERT algorithm: a randomized trial. European Journal of Emergency Medicine. 2015; D1500191.
DOI: http://dx.doi.org/10.18103/imr.v2i8.94
Refbacks
- There are currently no refbacks.