Effectiveness of training emergency medical dispatchers in remote consultation on first aid for cardiac arrest

Aim. To conduct an experimental evaluation of the effectiveness of training emergency medical service (EMS) specialists in remote consultation on first aid for cardiac arrest. Material and methods. This single-group quasi-experimental study assessed knowledge and practical skills before and after training in a three-day curriculum that included theoretical and practice training on first aid consultation in simulation scenarios with debriefings. A questionnaire consisting of 17 test items was used to assess knowledge, and a 15-item checklist was used to assess skills. The assessment of first aid skills was conducted in a simulated cardiac arrest scenario, in which a bystander performed first aid on a mannequin according to the dispatcher’s instructions. Results. The study sample consisted of 25 EMS dispatcher trainees. Following the training, the median [interquartile range, IQR] number of correct answers to test questions increased from 10,0 [7,0; 11,0] to 16,0 [15,0; 16,0] (p<0,001). Before training, dispatchers often failed to provide the basic elements of counseling necessary for an accurate and prompt assessment of the victim’s condition and providing bystanders with instructions. Consequently, in 44,0% of cases (n=11), chest compressions were not initiated by the bystander at all, and when compressions were performed, dispatchers’ instructions typically did not include language critical to proper compression technique. Before training, dispatchers provided unnecessary instructions to bystanders in 92,0% (n=23) of cases. The median [IQR] total practical skills score was initially 4,0 [2,0; 5,0], but increased significantly after completing the training, reaching 14,0 [13,5; 15,0] (p<0,001). After training, compressions were performed under dispatcher guidance in all cases, and generally observing key conditions for ensuring effective resuscitation. Unnecessary instructions were provided in one case (4,0%). Conclusion. EMS dispatcher training, combining theoretical training with the practice of algorithmic consultation skills in simulation scenarios with debriefings, significantly improved knowledge and skills in remote consultation regarding first aid during cardiac arrest and can be recommended for widespread implementation.