• Marine Riou, Stephen Ball, Teresa A Williams, Austin Whiteside, Peter Cameron, Daniel M Fatovich, Gavin D Perkins, Karen Smith, Janet Bray, Madoka Inoue, Kay L O'Halloran, Paul Bailey, Deon Brink, and Judith Finn.
• Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, WA 6102, Australia. Electronic address: marine.riou@curtin.edu.au.
• Resuscitation. 2018 Jan 1; 122: 92-98.

BackgroundIn emergency ambulance calls, agonal breathing remains a barrier to the recognition of out-of-hospital cardiac arrest (OHCA), initiation of cardiopulmonary resuscitation, and rapid dispatch. We aimed to explore whether the language used by callers to describe breathing had an impact on call-taker recognition of agonal breathing and hence cardiac arrest.MethodsWe analysed 176 calls of paramedic-confirmed OHCA, stratified by recognition of OHCA (89 cases recognised, 87 cases not recognised). We investigated the linguistic features of callers' response to the question "is s/he breathing?" and examined the impact on subsequent coding by call-takers.ResultsAmong all cases (recognised and non-recognised), 64% (113/176) of callers said that the patients were breathing (yes-answers). We identified two categories of yes-answers: 56% (63/113) were plain answers, confirming that the patient was breathing ("he's breathing"); and 44% (50/113) were qualified answers, containing additional information ("yes but gasping"). Qualified yes-answers were suggestive of agonal breathing. Yet these answers were often not pursued and most (32/50) of these calls were not recognised as OHCA at dispatch.ConclusionThere is potential for improved recognition of agonal breathing if call-takers are trained to be alert to any qualification following a confirmation that the patient is breathing.Copyright © 2017 Elsevier B.V. All rights reserved.

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