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Reasons 9-1-1 is called for cardiac arrest cases in which no resuscitation is attempted.

机译：对于没有进行任何复苏的心脏骤停的病例，要求使用原因9-1-1。

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OBJECTIVE: The goal of this investigation was to describe the reasons emergency medical services (EMS) is activated when resuscitation is not desired or when patients show signs of irreversible death. METHODS: All medical incident report forms (MIRFs) indicating a cardiac arrest for which resuscitation was withheld were obtained from five participating fire departments. For each eligible case (N = 196), one of the emergency medical technicians (EMTs) present at the scene was interviewed and the dispatch tape of the 9-1-1 call was reviewed. Patient and caller characteristics were abstracted from the MIRFs and dispatch tapes. The EMTs were asked about the reasons for the call, whether the family expected this death, and the caller's emotional state when EMS arrived at the scene. In addition, EMS providers were asked open-ended questions about the services they provided for the patient and patient's family. Using chi-square statistics and t-tests, we compared two groups: 1) patients for whom resuscitation was not desired as indicated by a do-not-resuscitate (DNR) order, terminal illness, or hospice (n = 66) and 2) patients for whom resuscitation was not started because of signs of irreversible death (n = 130). RESULTS: Compared with callers for patients with signs of irreversible death, callers for patients for whom resuscitation was not desired were less likely to access EMS because they needed medical assistance (11% versus 30%) and more likely to call 9-1-1 because they thought it was "required by law" (30% versus 8%). Other common reasons in both groups for activating 9-1-1 were confusion regarding what to do and a request to confirm death. The most frequently reported service provided by EMTs for both groups was to "offer to contact a chaplain." CONCLUSION: In a third of patients for whom EMS did not initiate resuscitation, resuscitation was withheld primarily because it was not desired rather than because there was evidence of irreversible death. Efforts to improve education may prevent EMS activation in these cases. An alternative EMS response could also help ensure patient autonomy and decrease costs to the EMS system.
机译：目的：本研究的目的是描述不希望进行复苏或患者出现不可逆转死亡迹象时激活紧急医疗服务（EMS）的原因。方法：从五个参与的消防部门获得了所有指示心脏骤停而未进行复苏的医疗事故报告表（MIRF）。对于每个符合条件的病例（N = 196），对在场的一名紧急医疗技术人员（EMT）进行了采访，并审查了9-1-1呼叫的派遣带。从MIRF和调度磁带中提取患者和呼叫者的特征。向EMT询问了电话的原因，家人是否预期死亡，以及EMS到达现场时呼叫者的情绪状态。此外，还向EMS提供者询问有关他们为患者和患者家庭提供的服务的开放性问题。使用卡方统计和t检验，我们将两组进行了比较：1）不进行复苏（DNR），绝症或临终关怀（n = 66）所指示的不需要复苏的患者; 2 ）由于不可逆死亡的迹象而未开始复苏的患者（n = 130）。结果：与有不可逆死亡迹象的呼叫者相比，不需要复苏的患者的呼叫者因需要医疗救助而获得急诊服务的可能性较小（11％对30％），并且更有可能致电9-1-1因为他们认为这是“法律要求”（30％对8％）。两组中激活9-1-1的其他常见原因是关于做什么和要求确认死亡的困惑。 EMT为两组提供的最频繁的服务是“提供联系牧师的服务”。结论：在没有进行EMS复苏的患者中，有1/3的患者因没有希望进行复苏而不是因为存在不可逆转死亡的证据而停止了复苏。在这些情况下，改善教育的努力可能会阻止EMS的激活。另一种EMS响应也可以帮助确保患者的自主权并降低EMS系统的成本。

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