Emergency Medical Dispatcher as a Link in the Chain of Survival in Out-Of-Hospital Cardiac Arrest
DOI:
https://doi.org/10.55707/jhs.v13i1.204Keywords:
out-of-hospital cardiac arrest, dispatcher-assisted cardiopulmonary resuscitation, basic resuscitation procedures, emergency medical careAbstract
Out-of-hospital cardiac arrest is a significant public health problem with a low survival rate. The medical dispatcher plays a key role in the chain of survival with an early recognition of the cardiac arrest and by leading the way in dispatcher-assisted resuscitation. A systematic review of the literature was conducted using the databases PubMed, SpringerLink, ProQuest in Web of Science, published between 2020 and 2025. Of the 257 searches, 10 articles were included in the final analysis and were analyzed using the qualitative content analysis. Three thematic categories were identified: recognition and treatment of the out-of-hospital cardiac arrest, interpersonal dynamics of the medical dispatcher and the caller, and systemic factors of the quality of dispatcher treatment. The medical dispatcher is not only a logistical coordinator, but an active link that directly influences the patient’s outcome. Effectiveness requires a coordinated action of the clinical-operational, interpersonal and systemic factors, continuous training and psychosocial support of medical dispatchers.
References
1. Baldi, E., Wnent, J., Caputo, M. L., Haywood, K. L., Lilja, G., Masterson, S., Nehme, Z., Perkins, G. D., Rosell-Ortiz, F., Strömsöe, A., Tjelmeland, I. B. M. in Graesner, J. T. (2025). European Resuscitation Council Guidelines 2025 Epidemiology in Resuscitation. Resuscitation, 215(1), 110733. https://doi.org/10.1016/j.resuscitation.2025.110733
2. Bray, J. E., Grasner, J. T., Nolan, J. P., Iwami, T., Ong, M. E. H., Finn, J., McNally, B., Nehme, Z., Sasson, C., Tijssen, J., Lim, S. L., Tjelmeland, I., Wnent, J., Dicker, B., Nishiyama, C., Doherty, Z., Welsford, M. in Perkins, G. D. (2024). Cardiac arrest and cardiopulmonary resuscitation outcome reports: 2024 update of the Utstein out-of-hospital cardiac arrest registry template. Circulation, 150(9), e203–e223. https://doi.org/10.1161/CIR.0000000000001243
3. Buaprasert, P., Al-Araji, R., Rajdev, M., Vellano, K., Carr, M. J. in McNally, B. (2024). The past, present, and future of the Cardiac Arrest Registry to Enhance Survival (CARES). Resuscitation Plus, 18, 100624. https://doi.org/10.1016/j.resplu.2024.100624
4. Cabañas, J. G., Sasson, C., Abella, B. S., Aufderheide, T. P., Becker, L. B., Dainty, K. N., Malta-Hansen, C., Koster, R. W., Kurz, M. C., Marill, K. A., O’Connor, M., Panchal, A. R., Rittenberger, J. C., Salcido, D. D., Sayre, M. R., Snobelen, P., Starks, M. A. in Atkins, D. L. (2025). American Heart Association Automated External Defibrillator Symposium: Summary and Recommendations. Journal of the American Heart Association, 14(7), e039291. https://doi.org/10.1161/JAHA.124.039291
5. Dainty, K. N., Debaty, G., Waddick, J., Vaillancourt, C., Malta Hansen, C., Olasveengen, T. in Bray, J. (2024). Interventions to optimize dispatcher-assisted CPR instructions: A scoping review. Resuscitation Plus, 19, 100715. https://doi.org/10.1016/j.resplu.2024.100715
6. Eberhard, K. E., Linderoth, G., Gregers, M. C. T., Lippert, F. in Folke, F. (2021). Impact of dispatcher-assisted cardiopulmonary resuscitation on neurologically intact survival in out-of-hospital cardiac arrest: A systematic review. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 29(1), 70. https://doi.org/10.1186/s13049-021-00875-5
7. Elhussain, M. O., Ahmed, F. K., Mustafa, N. M., Mohammed, D. O., Mahgoub, I. M., Alnaeim, N. A., Ali, R., Bushra, N., Ahamed, H. K. in Abdelrahman, N. (2023). The Role of Automated External Defibrillator Use in the Out-of-Hospital Cardiac Arrest Survival Rate and Outcome: A Systematic Review. Cureus. https://doi.org/10.7759/cureus.47721
8. Fink, A. in Mohar, A. (2023). Dispečerska služba zdravstva in sistem prvih posredovalcev. V R. Vajd in M. Zelinka (ur.), Urgentna medicina – izbrana poglavja 2023. 29. mednarodni simpozij o urgentni medicini (str. 72–75). Slovensko združenje za urgentno medicino.
9. Gram, K. H., Præst, M., Laulund, O. in Mikkelsen, S. (2021). Assessment of a quality improvement programme to improve telephone dispatchers’ accuracy in identifying out-of-hospital cardiac arrest. Resuscitation Plus, 6, 100096. https://doi.org/10.1016/j.resplu.2021.100096
10. Gräsner, J. T., Herlitz, J., Tjelmeland, I. B. M., Wnent, J., Masterson, S., Lilja, G., Bein, B., Böttiger, B. W., Rosell-Ortiz, F., Nolan, J. P., Bossaert, L. in Perkins, G. D. (2021). European Resuscitation Council Guidelines 2021: Epidemiology of cardiac arrest in Europe. Resuscitation, 161, 61–79. https://doi.org/10.1016/j.resuscitation.2021.02.007
11. Greif, R., Lauridsen, K. G., Djärv, T., Ek, J. E., Monnelly, V., Monsieurs, K. G., Nikolaou, N., Olasveengen, T. M., Semeraro, F., Spartinou, A., Yeung, J., Baldi, E., Biarent, D., Djakow, J., Van Gils, M., Van Goor, S., Gräsner, J.-T., Hogeveen, M., Karageorgos, V., … Kiebooms, E. (2025). European Resuscitation Council Guidelines 2025 Executive Summary. Resuscitation, 215, 110770. https://doi.org/10.1016/j.resuscitation.2025.110770
12. Han, Y., Hu, H., Shao, Y., Deng, Z. in Liu, D. (2024). The link between initial cardiac rhythm and survival outcomes in in-hospital cardiac arrest using propensity score matching, adjustment, and weighting. Scientific Reports, 14(1), 7621. https://doi.org/10.1038/s41598-024-58468-y
13. Hardeland, C., Claesson, A., Blom, M. T., Blomberg, S. N. F., Folke, F., Hollenberg, J., Kramer-Johansen, J., Lippert, F., Nord, A., Nygaard, A. M., Olasveengen, T. M., Ringh, M., Svensson, L. in Møller, T. P. (2021). Description of call handling in emergency medical dispatch centres in Scandinavia: Recognition of out-of-hospital cardiac arrests and dispatcher-assisted CPR. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 29(1), 88. https://doi.org/10.1186/s13049-021-00903-4
14. Hussain, S. in Soldera, J. (2025). Telemedicine in cardiac arrest protocols: Comparative impact of video and audio dispatcher assistance. World Journal of Critical Care Medicine, 14(3). https://doi.org/10.5492/wjccm.v14.i3.103402
15. Imbriaco, G., Galazzi, A., Semeraro, F. in Ramacciati, N. (2025). Experiences, challenges, and best practices of dispatcher-assisted cardiopulmonary resuscitation: A scoping review. Internal and Emergency Medicine, 20(6), 1869–1900. https://doi.org/10.1007/s11739-025-03991-7
16. Järvenpää, V., Korpela, S. P., Mäki, P., Huhtala, H., Setälä, P. in Hoppu, S. (2025). Prompt dispatcher-initiated tele-CPR and facilitation of bystander’s CPR to improve out-of-hospital cardiac arrest outcomes: A prospective cohort study from Finland. Resuscitation, 215, 110755. https://doi.org/10.1016/j.resuscitation.2025.110755
17. Juul Grabmayr, A., Dicker, B., Dassanayake, V., Bray, J., Vaillancourt, C., Dainty, K. N., Olasveengen, T. in Malta Hansen, C. (2024). Optimising telecommunicator recognition of out-of-hospital cardiac arrest: A scoping review. Resuscitation Plus, 20, 100754. https://doi.org/10.1016/j.resplu.2024.100754
18. Khalili, M., Lingawi, S., Hutton, J., Fordyce, C. B., Christenson, J., Shadgan, B., Grunau, B. in Kuo, C. (2024). Detecting cardiac states with wearable photoplethysmograms and implications for out-of-hospital cardiac arrest detection. Scientific Reports, 14(1), 23185. https://doi.org/10.1038/s41598-024-74117-w
19. Kordeš, U. in Smrdu, M. (2015). Osnove kvalitativnega raziskovanja. Založba Univerze na Primorskem. https://www.hippocampus.si/ISBN/978-961-6963-98-5.pdf
20. Kovoor, J. G., Jerrow, R., Cork, S., Page, G. J., Jui, J., Chugh, S. S., Finn, C. M. in Kovoor, P. (2025). Gaps in Public Access Defibrillation. JACC: Advances, 4(2), 101573. https://doi.org/10.1016/j.jacadv.2024.101573
21. Mohar, A. (2024). Dispečersko podprto oživljanje – izkušnje v Sloveniji. V R. Vajd in M. Zelinka (ur.), Urgentna medicina – izbrana poglavja 2024. 30. mednarodni simpozij o urgentni medicini (str. 125–128). Slovensko združenje za urgentno medicino.
22. Nguyen, D. D., Spertus, J. A., Kennedy, K. F., Gupta, K., Uzendu, A. I., McNally, B. F. in Chan, P. S. (2024). Association Between Delays in Time to Bystander CPR and Survival for Witnessed Cardiac Arrest in the United States. Circulation: Cardiovascular Quality and Outcomes, 17(2). https://doi.org/10.1161/CIRCOUTCOMES.123.010116
23. Oliveira, N. C., Oliveira, H., Silva, T. L. C., Boné, M. in Bonito, J. (2025). The role of bystander CPR in out-of-hospital cardiac arrest: What the evidence tells us. Hellenic Journal of Cardiology, 82, 86–98. https://doi.org/10.1016/j.hjc.2024.09.002
24. Osório, C., Talwar, S., Stevelink, S. A. M., Sihre, H. K., Lamb, D. in Billings, J. (2025). Systematic review and meta-analysis on the mental health of emergency and urgent call-handlers and dispatchers. Occupational Medicine, 75(6), 282–291. https://doi.org/10.1093/occmed/kqae104
25. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, n71. https://doi.org/10.1136/bmj.n71
26. Perera, N., Birnie, T., Whiteside, A., Ball, S. in Finn, J. (2023). “If you miss that first step in the chain of survival, there is no second step” – Emergency ambulance call-takers’ experiences in managing out-of-hospital cardiac arrest calls. PLOS ONE, 18(3), e0279521. https://doi.org/10.1371/journal.pone.0279521
27. Petravić, L., Miklič, R., Burger, E., Keše, U., Kulovec, D., Poljanšek, E., Tomšič, G., Pintarič, T., Lopes, M. F., Brezovnik, M. in Strnad, M. (2024). Enhancing Bystander Intervention: Insights from the Utstein Analysis of Out-of-Hospital Cardiac Arrests in Slovenia. Medicina, 60(8), 1227. https://doi.org/10.3390/medicina60081227
28. Polit, D. F. in Beck, C. T. (2021). Nursing research: Generating and assessing evidence for nursing practice (Eleventh edition, international edition). Wolters Kluwer.
29. Rakić, D., Luetić, L., Jurišić, Z., Berović, N., Cvitković, I. in Rumboldt, Z. (2024). Public Access Early Defibrillation – Past, Present, and Future. Cardiologia Croatica, 19(5–6), 195–206. https://doi.org/10.15836/ccar2024.195
30. Rasmussen, S. E., Nebsbjerg, M. A., Bomholt, K. B., Krogh, L. Q., Krogh, K., Povlsen, J. A. in Løfgren, B. (2020). Major Differences in the Use of Protocols for Dispatcher-Assisted Cardiopulmonary Resuscitation Among ILCOR Member Countries. Open Access Emergency Medicine, 12, 67–71. https://doi.org/10.2147/OAEM.S236038
31. Sanko, S., Feng, S., Lane, C. in Eckstein, M. (2021). Comparison of Emergency Medical Dispatch Systems for Performance of Telecommunicator-Assisted Cardiopulmonary Resuscitation Among 9-1-1 Callers With Limited English Proficiency. JAMA Network Open, 4(6), e216827. https://doi.org/10.1001/jamanetworkopen.2021.6827
32. Semeraro, F., Schnaubelt, S., Olasveengen, T. M., Bignami, E. G., Böttiger, B. W., Fijačko, N., Gamberini, L., Hansen, C. M., Lockey, A., Metelmann, B., Metelmann, C., Ristagno, G., Van Schuppen, H., Thilakasiri, K. in Monsieurs, K. G. (2025). European Resuscitation Council Guidelines 2025 System Saving Lives. Resuscitation, 215, 110821. https://doi.org/10.1016/j.resuscitation.2025.110821
33. Siddiqui, F. J., McNally, B., Gräsner, J. T., Ho, A. F. W., Tjelmeland, I., Iwami, T., Bray, J., Wnent, J., Lynn Lim, S., Pin Pek, P., Do Shin, S., Ong, M. E. H., Siddiqui, F. J., McNally, B., Gräsner, J.-T., Ho, A. F. W., Tjelmeland, I., Iwami, T., Bray, J., … Hock Ong, M. E. (2024). Towards advancing Out-of-Hospital cardiac arrest (OHCA) registries globally: Considerations from the global OHCA registry (GOHCAR) collaborative. Resuscitation Plus, 18, 100615. https://doi.org/10.1016/j.resplu.2024.100615
34. Smyth, M. A., Van Goor, S., Hansen, C. M., Fijačko, N., Nakagawa, N. K., Raffay, V., Ristagno, G., Rogers, J., Scquizzato, T., Smith, C. M., Spartinou, A., Wolfgang, K. in Perkins, G. D. (2025). European Resuscitation Council Guidelines 2025 Adult Basic Life Support. Resuscitation, 215, 110771. https://doi.org/10.1016/j.resuscitation.2025.110771
35. Sohn, Y., Cho, G. C. in Cho, Y. (2022). The interaction effect of bystander cardiopulmonary resuscitation (CPR) and dispatcher CPR on outcomes after out-of-hospital cardiac arrest. Scientific Reports, 12(1), 22450. https://doi.org/10.1038/s41598-022-27096-9
36. Stieglis, R., Van Eeden, V. G. M., Blom, M. T., Koster, R. W. in Van Schuppen, H. (2025b). Distance between OHCA and AED location within a community first responder system to achieve early AED connection. Resuscitation, 215, 110721. https://doi.org/10.1016/j.resuscitation.2025.110721
37. Stieglis, R., Verkaik, B. J., Tan, H. L., Koster, R. W., Van Schuppen, H. in Van Der Werf, C. (2025a). Association Between Delay to First Shock and Successful First-Shock Ventricular Fibrillation Termination in Patients With Witnessed Out-of-Hospital Cardiac Arrest. Circulation, 151(3), 235–244. https://doi.org/10.1161/CIRCULATIONAHA.124.069834
38. Tamminen, J., Lydén, E., Kurki, J., Huhtala, H., Kämäräinen, A. in Hoppu, S. (2020). Spontaneous trigger words associated with confirmed out-of-hospital cardiac arrest: A descriptive pilot study of emergency calls. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 28(1), 1. https://doi.org/10.1186/s13049-019-0696-1
39. Tuffley, R. H., Folke, F., Ersbøll, A. K., Blomberg, S. N. F. in Linderoth, G. (2023). Is dispatcher-assisted cardiopulmonary resuscitation affected by a bystander’s emotional stress state in out-of-hospital cardiac arrest? Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 31(1), 82. https://doi.org/10.1186/s13049-023-01117-6
40. Vo, J., Norby, F. L., Marano, P., Matusov, Y., Reinier, K., Ebinger, J., Halperin, H. in Chugh, S. S. (2024). Management and prevention of in-hospital cardiac arrest: Present and future. npj Cardiovascular Health, 1(1), 7. https://doi.org/10.1038/s44325-024-00009-7
41. Wilkinson, C., Bhatty, A., Batra, G., Aktaa, S., Smith, A. B., Dwight, J., Ruciński, M., Chappell, S., Alfredsson, J., Erlinge, D., Ferreira, J., Guðmundsdóttir, I. J., Hrafnkelsdóttir, Þ. J., Ingimarsdóttir, I. J., Irs, A., Jánosi, A., Járai, Z., Oliveira-Santos, M., Popescu, B. A., … Gale, C. P. (2024). Definitions of clinical study outcome measures for cardiovascular diseases: The European Unified Registries for Heart Care Evaluation and Randomized Trials (EuroHeart). European Heart Journal, 46(2), 190–214. https://doi.org/10.1093/eurheartj/ehae724
42. Żądło, A., Wilczek, D., Cebula, G., Orzechowska, D. in Tokarek, T. (2025). Impact of bystander and dispatcher interventions on clinical outcomes in Out-of-Hospital Cardiac Arrest: A Study of 8,253 Polish Cases from the European Registry of Cardiac Arrest. https://doi.org/10.1101/2025.01.05.24319824
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