Читать книгу Emergency Medical Services - Группа авторов - Страница 298

The most important first steps in cardiac arrest care are recognition of the event and summoning help. These actions require widespread public understanding of OHCA, how to recognize OHCA, and the importance of immediate action.

The methods for teaching laypersons to recognize OHCA have evolved over recent years. Many studies have described the difficulty and delays caused by laypersons attempting to feel for a pulse [31]. Even trained EMTs had difficulty detecting the presence or absence of a pulse in patients undergoing cardiac bypass during open‐heart surgery [32]. Thus, current American Heart Association (AHA) guidelines advise that bystanders should call 9‐1‐1 and begin treatment for OHCA if the person has no movement and no regular breathing. Bystanders must not mistake agonal gasps for normal breathing [33].

Emergency medical dispatch is essential to cardiac arrest care. Public safety answering points must quickly and accurately recognize potential cardiac arrest calls and promptly dispatch appropriate first responder and EMS units. Providing pre‐arrival instructions for bystander CPR and AED use is another important role for the telecommunicator. Telecommunicator instruction in CPR improves the likelihood of the caller performing CPR (see Chapter 88) [34].