Dispatch-assisted CPR: where are the hold-ups during calls to emergency dispatchers? A preliminary analysis of caller-dispatcher interactions during out-of-hospital cardiac arrest using a novel call transcription technique.

BACKGROUND: Survival from out-of-hospital cardiac arrest (OHCA) is dependent on the chain of survival. Early recognition of cardiac arrest and provision of bystander cardiopulmonary resuscitation (CPR) are key determinants of OHCA survival. Emergency medical dispatchers play a key role in cardiac arrest recognition and giving telephone CPR advice. The interaction between caller and dispatcher can influence the time to bystander CPR and quality of resuscitation. We sought to pilot the use of emergency call transcription to audit and evaluate the holdups in performing dispatch-assisted CPR. METHODS: A retrospective case selection of 50 consecutive suspected OHCA was performed. Audio recordings of calls were downloaded from the emergency medical dispatch centre computer database. All calls were transcribed using proprietary software and voice dialogue was compared with the corresponding stage on the Medical Priority Dispatch System (MPDS). Time to progress through each stage and number of caller-dispatcher interactions were calculated. RESULTS: Of the 50 downloaded calls, 47 were confirmed cases of OHCA. Call transcription was successfully completed for all OHCA calls. Bystander CPR was performed in 39 (83%) of these. In the remaining cases, the caller decided the patient was beyond help (n = 7) or the caller said that they were physically unable to perform CPR (n = 1). MPDS stages varied substantially in time to completion. Stage 9 (determining if the patient is breathing through airway instructions) took the longest time to complete (median = 59 s, IQR 22-82 s). Stage 11 (giving CPR instructions) also took a relatively longer time to complete compared to the other stages (median = 46 s, IQR 37-75 s). Stage 5 (establishing the patient's age) took the shortest time to complete (median = 5.5s, IQR 3-9s). CONCLUSION: Transcription of OHCA emergency calls and caller-dispatcher interaction compared to MPDS stage is feasible. Confirming whether a patient is breathing and completing CPR instructions required the longest time and most interactions between caller and dispatcher. Use of call transcription has the potential to identify key factors in caller-dispatcher interaction that could improve time to CPR and further research is warranted in this area.

Behavior matching in multimodal communication is synchronized.

A variety of theoretical frameworks predict the resemblance of behaviors between two people engaged in communication, in the form of coordination, mimicry, or alignment. However, little is known about the time course of the behavior matching, even though there is evidence that dyads synchronize oscillatory motions (e.g., postural sway). This study examined the temporal structure of nonoscillatory actions-language, facial, and gestural behaviors-produced during a route communication task. The focus was the temporal relationship between matching behaviors in the interlocutors (e.g., facial behavior in one interlocutor vs. the same facial behavior in the other interlocutor). Cross-recurrence analysis revealed that within each category tested (language, facial, gestural), interlocutors synchronized matching behaviors, at temporal lags short enough to provide imitation of one interlocutor by the other, from one conversational turn to the next. Both social and cognitive variables predicted the degree of temporal organization. These findings suggest that the temporal structure of matching behaviors provides low-level and low-cost resources for human interaction.

Determiner selection in romance languages: evidence from French.

Determiner selection requires the retrieval of the noun's syntactic features (e.g., gender) and sometimes of its phonological features. Miozzo and Caramazza (1999) argued that the selection of determiners in Germanic languages is more straightforward than in Romance languages because it is not dependent on the phonological properties of the following word. In the present study, we used the picture-word interference paradigm to investigate the dependency of the determiner on the noun's features in French. In 3 experiments, we found a gender congruency effect at +200 stimulus onset asynchrony (SOA), indicating that participants were slower to produce the name of a picture (determiner + noun) when the picture-word pair was incongruent in gender than when it was congruent. We failed to replicate this effect at 0 SOA, in line with previous studies (Alario & Caramazza, 2002). Our results suggest that the features involved in determiner selection are not language specific but rather are specific to the determiner system.

Grammatical gender in the production of single words: some evidence from Greek.

The present study investigated the effect of prior grammatical gender information provided by the production of a bare noun on the production of a syntactically unrelated, gender-inflected color adjective. The target language was Greek. A lexical priming task involving picture naming was employed. Participants saw a series of pictures, some in color and some in black-and-white; they had to name a black-and-white picture with the single noun (prime) and a color picture with the appropriately inflected color adjective (target). Prior gender information was shown to affect subsequent production of gender-marked words. The effect was restricted to nouns of one gender class (masculine) only. The implications of these results for the representation and processing of gender in production are discussed.