Medical dispatchers' perception of visual information in real out-of-hospital cardiac arrest: a qualitative interview study.
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ABSTRACT:
SUBMITTER: Linderoth G
PROVIDER: S-EPMC6347804 | biostudies-literature | 2019 Jan
REPOSITORIES: biostudies-literature
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Medical dispatchers' perception of visual information in real out-of-hospital cardiac arrest: a qualitative interview study.
Linderoth Gitte G Møller Thea Palsgaard TP Folke Fredrik F Lippert Freddy K FK Østergaard Doris D
Scandinavian journal of trauma, resuscitation and emergency medicine 20190125 1
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Project description:BackgroundMedical dispatching is a highly complex procedure and has an impact upon patient outcome. It includes call-taking and triage, prioritization of resources and the provision of guidance and instructions to callers. Whilst emergency medical dispatchers play a key role in the process, their perception of the process is rarely reported. We explored medical dispatchers' perception of the interaction with the caller during emergency calls. Secondly, we aimed to develop a model for emergency call handling based on these findings.MethodsTo provide an in-depth understanding of the dispatching process, an explorative qualitative interview study was designed. A grounded theory design and thematic analysis were applied.ResultsA total of 5 paramedics and 6 registered nurses were interviewed. The emerging themes derived from dispatchers' perception of the emergency call process were related to both the callers and the medical dispatchers themselves, from which four and three themes were identified, respectively. Dispatchers reported that for callers, the motive for calling, the situation, the perception and presentation of the problem was influencing factors. For the dispatchers the expertise, teamwork and organization influenced the process. Based on the medical dispatchers´ perception, a model of the workflow and interaction between the caller and the dispatcher was developed based on themes related to the caller and the dispatcher.ConclusionsAccording to medical dispatchers, the callers seem to lack knowledge about best utilization of the emergency number and the medical dispatching process, which can be improved by public awareness campaigns and incorporating information into first aid courses. For medical dispatchers the most potent modifiable factors were based upon the continuous professional development of the medical dispatchers and the system that supports them. The model of call handling underlines the complexity of medical dispatching that embraces the context of the call beyond clinical presentation of the problem.
| S-EPMC7941984 | biostudies-literature
Project description:BackgroundMedical dispatchers have limited information to assess the appropriate emergency response when citizens call the emergency number. We explored whether live video from bystanders' smartphones changed emergency response and was beneficial for the dispatcher and caller.MethodsFrom June 2019 to February 2020, all medical dispatchers could add live video to the emergency calls at Copenhagen Emergency Medical Services, Denmark. Live video was established with a text message link sent to the caller's smartphone using GoodSAM®. To avoid delayed emergency response if the video transmission failed, the medical dispatcher had to determine the emergency response before adding live video to the call. We conducted a cohort study with a historical reference group. Emergency response and cause of the call were registered within the dispatch system. After each video, the dispatcher and caller were given a questionnaire about their experience.ResultsAdding live video succeeded in 838 emergencies (82.2% of attempted video transmissions) and follow-up was possible in 700 emergency calls. The dispatchers' assessment of the patients' condition changed in 51.1% of the calls (condition more critical in 12.9% and less critical in 38.2%), resulting in changed emergency response in 27.5% of the cases after receiving the video (OR 1.58, 95% CI: 1.30-1.91) compared to calls without video. Video was added more frequently in cases with sick children or unconscious patients compared with normal emergency calls. The dispatcher recognized other or different disease/trauma in 9.9% and found that patient care, such as the quality of cardiopulmonary resuscitation, obstructed airway or position of the patient, improved in 28.4% of the emergencies. Only 111 callers returned the questionnaire, 97.3% of whom felt that live video should be implemented.ConclusionsIt is technically feasible to add live video to emergency calls. The medical dispatcher's perception of the patient changed in about half of cases. The odds for changing emergency response were 58% higher when video was added to the call. However, use of live video is challenging with the existing dispatch protocols, and further implementation science is necessary.
| S-EPMC8419944 | biostudies-literature
Project description:ObjectiveTo explore what information sources medical specialists currently use to inform their medical decision-making.DesignQualitative, semistructured interviews.Setting and participantsA total of 20 semistructured interviews were conducted with 10 surgeons and 10 internal medicine specialists who work in academic and/or regional hospitals in the Netherlands.ResultsMedical specialists reported that they primarily rely on their general knowledge and experience, rather than actively using information sources. The sources they use to update their knowledge can be categorised into 'scientific publications', 'guidelines or protocols', and 'presentations and meetings'. When medical specialists feel their general knowledge and experience are insufficient, they use three different approaches to find answers in response to clinical questions: consulting a colleague, actively searching the literature and asking someone else to search the literature.ConclusionMedical specialists use information sources to update their general knowledge and to find answers to specific clinical questions when they feel their general knowledge and experience are insufficient. An important finding is that medical specialists prefer accessible information sources (eg, consulting colleagues) over existing evidence-based medicine tools.
| S-EPMC10565272 | biostudies-literature
Project description:IntroductionEarly recognition of out-of-hospital cardiac arrest (OHCA) by the medical dispatcher is a prerequisite for an effective chain of survival, leading to rapid dispatch of emergency medical services.AimTo analyse and compare the accuracy of the Emergency Medical Dispatch Centre in identifying OHCA before and after an educational intervention.MethodsA quality-assessment study collecting data from prehospital medical voice logs in Southern Denmark during two periods. Baseline data and post-interventional data were obtained during December, January, and February 2017/2018 and 2019/2020, respectively. We imposed an intervention consisting of a specifically targeted education in quick assessment of OHCA and instructions regarding telephone-assisted-CPR.The primary outcome measure was the dispatcher's ability to recognise OHCA. Secondary outcome measures were time from contact with the caller to the dispatcher formulated essential questions related to the NO-NO-GO algorithm. These questions included an assessment of the patients' consciousness and respiratory efforts and if both negative, would ideally lead to the dispatcher initiating telephone-assisted-CPR. All data was analysed in accordance with the recommendations and performance goals made by Resuscitation Academy.ResultsBaseline data included 209 calls. Post-interventional data was based on 208 calls.The sensitivity for recognition of OHCA was 82.3% (95% CI: 76.4-87.2%) before and 92.7% (95% CI: 88.2-95.8%) after the intervention (p = 0.0014). The median duration of calls before recognition of OHCA was 68 and 56 s before and after the intervention (p = 0.097).ConclusionAfter the period of intervention, the accuracy of OHCA recognition by dispatchers improved. The median time to identify OHCA or recognise the first compression did not differ significantly. This indicates that continuing education and quality assessment may be beneficial and necessary.
| S-EPMC8244530 | biostudies-literature
Project description:ObjectivesVideo streaming has recently been introduced as an additional tool for communication between medical dispatchers and caller. Research implies that video streaming may be a useful tool for the dispatchers, but more knowledge is needed. With this study, we wanted to explore how the dispatchers experience using video streaming as an additional tool in medical emergency calls.DesignAn explorative, qualitative study using semi-structured focus group interviews.SettingTwo emergency medical communications centres in Norway where video streaming recently had been introduced. Interviews were conducted during 24 June 2020 and 26 June 2020.ParticipantsWe recruited 25 medical dispatchers, either nurses or emergency medical technicians who worked at the two centres.ResultsThe results are categorised into three themes: (1) change in dispatcher's perception of the patient and the situation, (2) reassurance for the dispatcher and (3) worries about increased time consumption and the possibility of unpleasant images.ConclusionThe dispatchers experienced that the use of video streaming in medical emergency calls might contribute to a better comprehension of the situation and following more precise resource allocation, as well as greater reassurance for the dispatcher and improved relationship between the dispatcher and the caller. Further research with an aim to measure effects and safety of video streaming during medical emergency calls is needed.
| S-EPMC9764601 | biostudies-literature
Project description:BackgroundVision provides the most salient information with regard to the stimulus motion. However, it has recently been demonstrated that static visual stimuli are perceived as moving laterally by alternating left-right sound sources. The underlying mechanism of this phenomenon remains unclear; it has not yet been determined whether auditory motion signals, rather than auditory positional signals, can directly contribute to visual motion perception.Methodology/principal findingsStatic visual flashes were presented at retinal locations outside the fovea together with a lateral auditory motion provided by a virtual stereo noise source smoothly shifting in the horizontal plane. The flash appeared to move by means of the auditory motion when the spatiotemporal position of the flashes was in the middle of the auditory motion trajectory. Furthermore, the lateral auditory motion altered visual motion perception in a global motion display where different localized motion signals of multiple visual stimuli were combined to produce a coherent visual motion perception.Conclusions/significanceThese findings suggest there exist direct interactions between auditory and visual motion signals, and that there might be common neural substrates for auditory and visual motion processing.
| S-EPMC3052321 | biostudies-literature
Project description:ObjectiveTo explore men`s perception of information and their possible emotional strain in the diagnostic phase of prostate cancer.Design, setting, patientsA qualitative explorative research design was employed. Data were collected from June to November 2017. The study was set at a urological outpatient clinic at a university hospital in Norway. Semi-structured interviews were conducted with ten men who had been examined for prostate cancer. Interviews were analyzed using Systematic Text Condensation (STC).ResultsThe analysis revealed three themes. The theme 'Different needs and perceptions of information' illustrated that information should be personalized. Despite different information needs, insufficient information about prostate cancer may prevent some men from being involved in decisions. The theme, 'A discovery of not being alone', indicated that a sense of affinity occurs when men realize the commonality of prostate cancer. Some men benefited from other men's experiences and knowledge about prostate cancer. The last theme 'Worries about cancer and mortality' showed that the emotional strain was affected by men's knowledge of cancer and the received information. Men expressed conflicting feelings toward prostate cancer that could be difficult to express.ConclusionsThe findings indicate that men in the diagnostic phase of prostate cancer are not a homogeneous group, but need personalized information. Some men may benefit from other men's experiences and support. Men's emotional strain can affect their communication about prostate cancer, which should be acknowledged. Procedures that identify patients' information needs early on should be an integrated part of the diagnostic phase of prostate cancer.KEY POINTSKnowledge about men's information needs and possible emotional strain in the diagnostic phase of prostate cancer are limited.Men with suspected prostate cancer have different preferences and information needs; however, insufficient information prevents men from participating in decisions.Men experience a sense of affinity with other men affected by prostate cancer, and some men benefit from exchanging experiences.Men consider prostate cancer as a less aggressive type of cancer but may experience emotional strain.
| S-EPMC8725825 | biostudies-literature
Project description:BackgroundStudents may be the first to recognise and respond to psychological distress in other students. Peer support could overcome medical student reluctance to seek help despite their high rates of mental ill-health. Yet, despite the adoption of peer support programs, there is little evidence of impact on students. Peer support programs may assume that medical students accept and view peer support positively. We explored these assumptions by asking students about their experiences and views on peer support.MethodsQualitative semi-structured interviews exploring peer support experiences and views on peer support were conducted with ten medical students at two contrasting medical schools. Informed by a constructivist stance, interview transcripts underwent thematic analysis.ResultsThree groups of themes were identified: participants' experiences of peer support encounters, concerns about providing support, and views on students' roles in peer support. Participants readily recalled signs of peer distress. Encounters were ad hoc, informal, and occurred within relationships based on friendship or by being co-located in the same classes or placements. Concerns about initiating and offering support included lack of expertise, maintaining confidentiality, stigma from a mental health diagnosis, and unclear role boundaries, with implications for acceptance of student roles in peer support.ConclusionsOur study emphasised the centrality of social relationships in enabling or discouraging peer support. Relationships developed during medical studies may anticipate the collegial relationships between medical professionals. Nevertheless, only some students are willing to undertake peer support roles. We suggest different strategies for promoting informal peer support that can be offered by any student, to those promoting formal support roles for selected students. Future research focusing on the impact for both the students who receive, and on the students who provide peer support is called for.
| S-EPMC9027875 | biostudies-literature
Project description:Humans have an astonishing ability to extract hidden information from the movement of others. In previous work, subjects observed the motion of a simulated stick-figure, two-link planar arm and estimated its stiffness. Fundamentally, stiffness is the relation between force and displacement. Given that subjects were unable to physically interact with the simulated arm, they were forced to make their estimates solely based on observed kinematic information. Remarkably, subjects were able to correctly correlate their stiffness estimates with changes in the simulated stiffness, despite the lack of force information. We hypothesized that subjects were only able to do this because the controller used to produce the simulated arm's movement, composed of oscillatory motions driving mechanical impedances, resembled the controller humans use to produce their own movement. However, it is still unknown what motion features subjects used to estimate stiffness. Human motion exhibits systematic velocity-curvature patterns, and it has previously been shown that these patterns play an important role in perceiving and interpreting motion. Thus, we hypothesized that manipulating the velocity profile should affect subjects' ability to estimate stiffness. To test this, we changed the velocity profile of the simulated two-link planar arm while keeping the simulated joint paths the same. Even with manipulated velocity signals, subjects were still able to estimate changes in simulated joint stiffness. However, when subjects were shown the same simulated path with different velocity profiles, they perceived motions that followed a veridical velocity profile to be less stiff than that of a non-veridical profile. These results suggest that path information (displacement) predominates over temporal information (velocity) when humans use visual observation to estimate stiffness.
| S-EPMC9731484 | biostudies-literature
Project description:Perception is fundamentally underconstrained because different combinations of object properties can generate the same sensory information. To disambiguate sensory information into estimates of scene properties, our brains incorporate prior knowledge and additional "auxiliary" (i.e., not directly relevant to desired scene property) sensory information to constrain perceptual interpretations. For example, knowing the distance to an object helps in perceiving its size. The literature contains few demonstrations of the use of prior knowledge and auxiliary information in combined visual and haptic disambiguation and almost no examination of haptic disambiguation of vision beyond "bistable" stimuli. Previous studies have reported humans integrate multiple unambiguous sensations to perceive single, continuous object properties, like size or position. Here we test whether humans use visual and haptic information, individually and jointly, to disambiguate size from distance. We presented participants with a ball moving in depth with a changing diameter. Because no unambiguous distance information is available under monocular viewing, participants rely on prior assumptions about the ball's distance to disambiguate their -size percept. Presenting auxiliary binocular and/or haptic distance information augments participants' prior distance assumptions and improves their size judgment accuracy-though binocular cues were trusted more than haptic. Our results suggest both visual and haptic distance information disambiguate size perception, and we interpret these results in the context of probabilistic perceptual reasoning.
| S-EPMC2832682 | biostudies-literature