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L.A. officials to probe CPR delays involving 911 calls

City officials plan to look into an LAFD study that raises concerns about time-consuming questions dispatchers must ask before giving CPR instructions or sending rescue units.

September 15, 2012|By Kate Linthicum, Robert J. Lopez and Ben Welsh, Los Angeles Times

Several Los Angeles officials on Friday said they would probe the findings of an internal Los Angeles Fire Department report detailing delays in getting 911 callers to begin CPR on cardiac arrest victims.

The study, disclosed by The Times this week, found LAFD dispatchers waste valuable time getting callers to start CPR, often beginning the life-saving procedure after the point at which brain death can begin. The study raised particular concerns about a time-consuming script of questions call-takers are required to ask before giving CPR instructions or dispatching rescue units.

City Councilwoman Jan Perry called on fire officials to make any necessary changes to call-handling protocols. "Maybe we need to condense and compress and be more efficient in how the questions are asked," said Perry, who is running for mayor. "I'm guessing that we do."

Fire Commissioner Andrew Friedman said his panel had not been presented with the report, but will investigate the issue. "If it is true that it takes four, four-and-a-half minutes to give CPR instructions then the methodology has to be changed and improved," he said.

The study found that chest compressions were started in only 31% of 166 cardiac arrest calls handled by dispatchers last October, in part because some callers were unwilling or unable to perform CPR. In cases in which CPR was begun, dispatchers took an average 4 minutes and 12 seconds to get the procedure started. When the heart stops beating, irreversible brain damage can begin after just four minutes.

LAFD's medical director, Dr. Marc Eckstein, said Friday that his department's dispatching system is "fundamentally sound" and officials are working as fast as possible to speed up responses in cardiac arrest cases. New guidelines aimed at permitting dispatchers to start CPR instructions sooner are under review and will take effect shortly, he said.

A series of 911 tapes included in the report showing long delays in CPR instructions are "extreme examples" and do not reflect the department's overall performance, he said. The report is evidence of a continuing effort by the LAFD to improve patient care, he added, saying, "the fact that we are being so self-critical is a great example of our quality improvement working."

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