Emotion displays in ambulance calls for out-of-hospital cardiac arrest: A qualitative inquiry of caller and call-taker communication.

INTRODUCTION

Caller emotion influences the flow of emergency ambulance calls for out-of-hospital cardiac arrest (OHCA) however limited research has examined how call-takers manage emotion. We aimed to identify how and where emotion manifests in OHCA calls and how call-takers respond.

METHODS

We analysed 107 consecutive OHCA calls to St John Western Australia (January-April 2021) containing emotion-related barriers to bystander cardiopulmonary resuscitation (B-CPR). Calls were ranked using the Emotional Content and Cooperation Score; 62 calls scoring 4 or 5 were included. We developed a schema of emotion displays, mapped their occurrence in calls, and transcribed call interactions. Conversation Analysis was used to examine interactional patterns.

RESULTS

Callers displayed emotion through shouting, crying, "wobbly voice," and impatience (e.g., "just send the ambulance!"). Emotion was heightened at call onset, initial questioning, and when callers had to move the patient for B-CPR. Call-takers managed emotion using directness, boundary-setting, and empathy; sometimes emotion was not explicitly addressed to maintain call progression.

CONCLUSIONS

Emotion is a disrupting factor in OHCA calls. Call-takers need a range of strategies to manage emotion according to the contexts in which they arise. Training using real-life call transcripts may enhance call-takers' skills, reducing delays in OHCA recognition and B-CPR.