| 1. |
- Hallikainen, J., et al.
(författare)
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The Wording of Telephone Guided CPRAffect on Senior Citizens Performance : A Simulation Study
- 2018
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Ingår i: Journal of Clinical Medicine. - : SM Group. - 2077-0383. ; 4:1
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To assess how senior citizens followed Telephone CPR (T-CPR) instructions in a simulated cardiac arrest scenario. Methods: Twenty-two voluntary senior citizens were studied in a simulated cardiac arrest scenario following the instructions given to them by an Emergency Medical Dispatcher. The phone calls and the CPR performance were recorded and analyzed. Results: The rescuers reported that they had performed better than the analysis of video and phone call recordings showed. When asked after the scenario the rescuers felt that they had coped with the situation well 72% and quite well 28% of the cases. Every participant evaluated the given telephone CPR instructions as very easy to understand. 35% of the participants thought that performing CPR was physically quite easy. The unexpected result was the EMDs’ bad protocol compliance. Protocol was not strictly followed by the dispatchers. They gave more straight forward instructions without the full knowledge of the situation, than they should have. From the 12 analyzed instructions that the dispatchers should have given to the rescuer, only three instructions (give two deep rescue breaths, correct positioning of the rescuers arms and to compress 15 times) were totally as in the protocol. Conclusions: The quality of CPR given by the senior citizens was inadequate in this study. The EMDs had bad protocol compliance. Standardized and feasible T-CPR instructions by the dispatcher are not seen in this study, even if the rescuers stated that the instructions were clear and easy to understand.
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| 2. |
- Ljungquist, Helena Nord, et al.
(författare)
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Communication and protocol compliance and their relation to the quality of cardiopulmonary resuscitation (CPR) : a mixed-methods study of simulated telephone-assisted CPR
- 2015
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Ingår i: International Emergency Nursing. - : Elsevier. - 1755-599X .- 1878-013X. ; 23:3, s. 254-259
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Forskningsöversikt (refereegranskat)abstract
- Background: In the event of a cardiac arrest, emergency medical dispatchers (EMDs) play a critical role by providing telephone-assisted cardiopulmonary resuscitation (T-CPR) to laypersons. The aim of our investigation was to describe compliance with the T-CPR protocol, the performance of the laypersons in a simulated T-CPR situation, and the communication between laypersons and EMDs during these actions. Methods: We conducted a retrospective observational study by analysing 20 recorded video and audio files. In a simulation, EMDs provided laypersons with instructions following T-CPR protocols. These were then analysed using a mixed method with convergent parallel design. Results: If the EMDs complied with the T-CPR protocol, the laypersons performed the correct procedures in 71% of the actions. The single most challenging instruction of the T-CPR protocol, for both EMDs and laypersons, was airway control. Mean values for compression depth and frequency did not reach established guideline goals for CPR. Conclusion: Proper application of T-CPR protocols by EMDs resulted in better performance by laypersons in CPR. The most problematic task for EMDs as well for laypersons was airway management. The study results did not establish that the quality of communication between EMDs and laypersons performing CPR in a cardiac arrest situation led to statistically different outcomes, as measured by the quality and effectiveness of the CPR delivered.
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| 3. |
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| 4. |
- Nord-Ljungquist, Helena, et al.
(författare)
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Lone and lonely in a double ambivalence situation as experienced by callers while waiting for the ambulance in a rural environment
- 2020
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 34:3, s. 566-574
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundIn a rural environment where distances and access to ambulance resources in people’s immediate area are limited, other responders like firefighters dispatched to perform a first aid before ambulance arrives in areas where a longer response time exists; an assignment called ‘While Waiting for the Ambulance’ (WWFA). Knowledge is limited about the experience from a caller’s perspective when a person has a life‐threatening condition needing emergency help and both firefighters in a WWFA assignment and ambulance staff are involved.AimThe aim of the study is to describe the emergency situation involving a WWFA assignment in a rural environment from the caller's perspective.MethodA descriptive design using qualitative methodology with a reflective lifeworld research (RLR) approach was used for this study, including in‐depth interviews with eight callers.ResultsAn emergency situation involving WWFA assignment in a rural environment mean a sense of being lone and lonely with a vulnerability in while waiting to hand over responsibility for the affected person. Ambivalence in several dimensions arises with simultaneous and conflicting emotions. A tension between powerlessness and power of action where the throw between doubt and hope are abrupt with a simultaneous pendulum between being in a chaos and in a calm.ConclusionA double ambivalence emerges between, on one hand feeling alone in the situation and having full control, on the other hand, with trust handing over the responsibility, thereby losing control. Contact with the emergency medical dispatcher becomes a saving lifeline to hold onto, and access to emergency help in the immediate area of WWFA is valuable and important. Trust and confidence are experienced when callers are met with empathy, regardless of personal acquaintance with arriving responders.
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| 5. |
- Nord-Ljungquist, Helena, et al.
(författare)
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‘Time is our utmost enemy’ : First responders’ experiences of ‘While Waiting For the Ambulance’ assignments in rural environments – A phenomenological study
- 2022
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Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 42:3, s. 166-174
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Tidskriftsartikel (refereegranskat)abstract
- Firefighters around the world have the ability to provide first aid before ambulance staff arrive. In Sweden, this assignment is called ‘While Waiting For the Ambulance’ (WWFA). There is limited knowledge about WWFA in rural environments, therefore the aim of this study was to describe the WWFA assignment in a rural environment from the perspective of the firefighters and the ambulance staff. A descriptive design was used with a reflective lifeworld approach, including 16 telephone interviews with firefighters and ambulance staff. The COREQ checklist was applied. A directed responsibility emerges towards affected persons with a situation-adapted attitude during alarms in a WWFA assignment. The firefighters and ambulance staff are each other’s support with a simultaneous need for support from involved organisations. To strengthen this support, training is required, consisting of interprofessional training, feedback from relevant organisations about first aid efforts and expansion of WWFA assignments. Finally, there is a need for a more coordinated picture in order to provide better conditions for future action by the organisations involved, with increased opportunities to save lives in individual local environments.
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| 6. |
- Nord-Ljungquist, Helena, et al.
(författare)
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"Time that save lives" while waiting for ambulance in rural environments
- 2021
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Ingår i: International Emergency Nursing. - : Elsevier. - 1755-599X .- 1878-013X. ; 59
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Tidskriftsartikel (refereegranskat)abstract
- AimFirefighters perform first aid before the ambulance arrives in areas with a long response time in Sweden; this is called ‘While Waiting for the Ambulance’ (WWFA). The aim was to describe WWFA assignments in rural environments, focusing on frequency, event time, actions and survival >30 days after cardiopulmonary resuscitation (CPR) was performed.MethodsRetrospective descriptive and comparative design.ResultsFirefighters in the northern part of Sweden were involved in 518 WWFA assignments between 2012 and 2016. From alarm call until ambulance dispatch, median time was 2:20 min; for firefighters, nearly four minutes. Median dispatch time at out-of-hospital cardiac arrests (OHCA) (n = 52) was 1:40 min for ambulance and three minutes for firefighters. Maximal dispatch time was nearly 10 min for ambulance and 44 min for firefighters. Firefighters arrived first at the scene, after 17 min’ median, for 95 % of assignments, while the ambulance took nearly twice the amount of time. In OHCA situations, time for firefighters was over 19 min versus ambulance at nearly twice the time. CPR was terminated by ambulance staff at 83% (n = 43) of 52 when firefighters performed prolonged CPR. Return to spontaneous circulation after OHCA was 17%, and 9% were alive after >30 days.ConclusionThe efficiency of incident time and utilisation rate for WWFA assignments can be increased for the benefit of affected persons, especially in OHCA.
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| 7. |
- Nord-Ljungquist, Helena
(författare)
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Vem har och tar ansvar! : – I Väntan På Ambulans (IVPA)-uppdrag i Glesbygdsmiljö
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The overall aim was to explore and describe experiences from the perspective of different actors in While Waiting for Ambulance (WWFA) assignments in a rural environment. The four studies aimed: to describe WWFA and ambulance assignments in rural environments, focusing on frequency, event time and actions of firefighters before an ambulance arrives at the scene, and to evaluate these actions (I); to describe emergency situations involving WWFA assignment in a rural environment from the caller´s perspective (II); to describe compliance with the telephone-assisted cardiopulmonary resuscitation (T-CPR) protocol, the performance of the laypersons in a simulated T-CPR situation, and the communication between laypersons and EMDs during these actions (III); to describe WWFA assignment in a rural environment from the firefighters’ and the ambulance staff’s perspective (IV).Methods: The studies had a descriptive and comparative design. They were analysed with a qualitative and quantitative methods.Results: In event time showed the process time between ambulance staff and firefighters as significantly statistically different, to firefighters' disadvantage. Nevertheless, firefighters arrived first at the scene for 95 % of assignments after 17 minutes in the median, while ambulance staff took nearly twice the time. Access to help in the immediate area is experienced as valuable to the callers, but there is also a sense of being lone and lonely with vulnerability. Instructions from T-CPR protocol were difficult to comply with both from EMDs and laypersons, especially airway control. Regardless of the quality of communication between EMD and lay people, performance of CPR did not improve. Firefighters and ambulance staff experienced a directedness of responsibility towards affected persons; simultaneously, they were each other’s support. WWFA assignment is, itself, in a gray zone between the involved organisations, and strategies are lacking for the assignment.Conclusions: WWFA assignments are an underutilized resource in individual’s local environments, where a coordinated picture of identified organisational gray zones provide better conditions for future action by the organisations involved, with increased opportunities to save lives in people's local environments.
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