Training 911 dispatchers to recognize symptoms

Researchers from UNC’s Schools of Public Health and Medicine surveyed 85 emergency dispatch centers in North Carolina between 2001 and 2002 to see what kind of training 911 dispatchers received for recognizing acute stroke or heart attack symptoms. The team found less than one-third of 911 dispatchers had received stroke or heart attack training.

Photograph of Dr. Kelly Evenson

“Stroke-like symptoms are subtle and require more discerning on the part of the 911 dispatcher,” said Kelly R. Evenson, Ph.D., research associate professor of epidemiology in the UNC School of Public Health. “If someone calls 911 complaining of chest pain, 911 dispatchers should recognize signs of a heart attack and know what to do to help the victim. But if someone calls complaining about feeling dizzy, having trouble holding his or her coffee cup or falling for no reason, the course of action is not as clear.”

The study appeared in the April 1, 2007 edition of the journal Prehospital Emergency Care. It was funded by a grant from the Duke Endowment and supported by the School of Medicine’s department of emergency medicine, the School of Public Health, and the Greensboro Area Health Education Center (AHEC).

Based on the survey results, the team concluded that a statewide telecommunication training program might increase the level of understanding of acute stroke and heart attack (myocardial infarction) by 911 dispatchers and improve the speed and level of emergency care these patients receive. As a result, the researchers developed an online stroke education program for 911 dispatchers and emergency workers that is available free of charge.

The team will publish data later this year on the impact of the online training, which already has been used by more than 530 dispatchers and 980 emergency medical service workers in North Carolina. The program is maintained by the Greensboro AHEC and can be found at www.aheconnect.com/rrs.

“We believe lives can be saved by training dispatchers – who are usually the first ones contacted in emergencies – to recognize symptoms of stroke and get help to people rapidly,” said Dr. Jane Brice, assistant professor in the School of Medicine’s department of emergency medicine. “Some departments already have good triage algorithms for stroke calls, but we believe by creating consistent and standard dispatching practices across the state, we can greatly improve the rapid response and care for acute stroke patients. The more they know about the symptoms of stroke, the more helpful they can be to people who need treatment quickly.”

Stroke is the third leading cause of death in North Carolina and the United States, according to the American Heart Association. Successful treatment depends on patients quickly getting help. However, less than 3 percent of stroke victims receive timely treatment, primarily because they do not arrive at the emergency department within three hours of the stroke.

Photograph of Dr. Wayne Rosamond

The survey was the first phase of the “North Carolina Rapid Response to Stroke” program, a three-year study. Co-investigators include Wayne Rosamond, Ph.D., professor of epidemiology; Julie Lellis, doctoral fellow in the School of Journalism and Mass Communication; Dr. Dexter Morris, clinical associate professor of emergency medicine; Dr. Ana Felix, clinical assistant professor of neurology; and David Kingdon, a School of Public Health graduate student at the time.

Note: Evenson can be reached at (919) 966-4187 or kelly_evenson@unc.edu. Dr. Brice can be reached at (919) 966-6440 or jbrice@med.unc.edu.

School of Public Health contact: Ramona DuBose, (919) 966-7467, ramona_dubose@unc.edu.

News Services contact: Becky Oskin, (919) 962-8596, becky_oskin@unc.edu.