Cardiac Arrest Recognition in Emergency Dispatch

Primary Purpose: Cardiac Arrest Recognition

The American Heart Association recommends that dispatchers use a systematic approach to identify cardiac arrest, which includes asking about descriptors such as "cold and stiff," "blue," "gray," or "pale" to help identify cardiac arrest cases, with a strength of evidence level of high 1
The American College of Cardiology suggests that dispatchers should use a streamlined 2-question approach to efficiently identify cardiac arrest, including asking if the patient is unresponsive/unconscious and if the patient is breathing normally, with a strength of evidence level of moderate 2, 3

The American Heart Association recommends that dispatchers ask two key questions to identify cardiac arrest: "Is the patient unresponsive/unconscious?" and "Is the patient breathing normally?", with a strength of evidence level of high 2, 3
If the answer is unresponsive with absent or abnormal breathing, the presumptive diagnosis is cardiac arrest and CPR instructions should begin immediately, with a strength of evidence level of high 2, 3

The American Heart Association notes that agonal breaths, which appear as slow, irregular gasping respirations, are often misinterpreted as normal breathing, occurring in 40-60% of cardiac arrest cases, with a strength of evidence level of moderate 1, 2
The American College of Cardiology states that early cardiac arrest recognition with immediate CPR improves survival by 2- to 3-fold, with a strength of evidence level of high 5
The risk of injury from CPR in patients not actually in cardiac arrest is only 1-2%, far outweighed by the lethal consequences of missing true cardiac arrest, with a strength of evidence level of moderate 4, 5