Dispatch codes of out-of-hospital cardiac arrest should be diagnosis related rather than symptom related.

Objective: To describe the characteristics and outcome in out-of-hospital cardiac arrest (OHCA) in relation to (i) whether OHCA was coded by the dispatcher as a diagnosis or as a symptom and (ii) the delay until the first unit was alerted at the dispatch centre. Methods: OHCA patients in Goteborg, during 17 months, excluding OHCA after calling the rescue team. Results: Among 250 cases, 20% were coded as a diagnosis (i.e. CA) with or without ongoing cardiopulmonary resuscitation (CPR). Dispatch codes for the remaining 200 patients (80%) were mostly symptom related (unconsciousness in 61%, codes related to breathing problems in 10%, other codes in 24% and missing in 5%). Patients in whom the dispatchers coded the call as CA had an earlier start to CPR after collapse (median 2 vs. 10 min; P<0.0001) and a higher rate of bystander CPR (86% vs. 42%; P<0.0001). Furthermore, they tended to have a higher rate of survival to hospital discharge (14.0% vs. 6.5%; P = 0.09). The median delay until the first unit was alerted was 1.8 min. Survival to hospital discharge was 10.0% if the delay was below median and 6.7% if the delay was above median (P = 0.48). Conclusion: Patients with OHCA who were not coded by dispatchers as such had a long delay to the start of CPR and a low survival. Dispatching according to diagnosis, that is, CA seems to improve these parameters most likely reflecting a more optimal communication between the dispatcher and the caller as well as the rescue team.