There can be several barriers to performing effective CPR on patients who call 911 service for help. One of the most challenging barriers is repositioning a patient found by the caller in a prone position i.e., on his/her belly. Existing medical dispatch pre-arrival instructions (on Medical Priority Dispatch System [MPDS®] Protocols Panel C2) provide no specific scripted instructions for repositioning the patient from prone to supine.
Research has showed that heart attacks present clinically with varying symptoms; and those symptoms are not always described by patients as chest pain or chest discomfort. Emergency Medical Dispatchers (EMDs) using the Medical Priority Dispatch System (MPDS™) are trained to select the Chest Pain/Chest Discomfort Protocol for non-chest pain heart attack symptoms or classic heart attack complaint of chest pain/chest discomfort. Nevertheless, it is still unknown how often callers report heart attack symptoms other than chest pain/chest discomfort, including what specific words/phrases they use to describe
The difficulty of evaluating the mental status, particularly alertness, is more pronounced in the medical dispatch context, where the Emergency Medical Dispatcher (EMD) must work through the eyes and ears of the caller, who is most likely a layperson. Determining true non-alertness and the level of its effects on outcome needs to be solved to perfect the interrogation and response-coding processes at dispatch.
