Views and perceptions of advanced life support practitioners on initiating, withholding and terminating resuscitation in out-of-hospital cardiac arrest in the Emergency Medical Services of South Africa
Views and perceptions of advanced life support practitioners on initiating, withholding and terminating resuscitation in out-of-hospital cardiac arrest in the Emergency Medical Services of South Africa
Blog Article
Introduction: This study aimed to explore the views and perceptions of Advanced Life Support (ALS) practitioners in two South African provinces on initiating, withholding, and terminating resuscitation in OHCA.Methodology: Semi-structured one-on-one interviews were conducted with operational ALS practitioners working within the prehospital setting in the Western Cape and Free State provinces.Recorded interviews were transcribed and subjected to inductive-dominant, here manifest content analysis.
After familiarisation with the data, meaning units were condensed, codes were applied and collated into categories that were then assessed, reviewed, and refined repeatedly.Results: A total of 18 ALS providers were interviewed.Five main categories were developed from the data analysis: 1) assessment of prognosis, 2) internal factors affecting decision-making, 3) external factors affecting decision-making, 4) system challenges, and 5) ideas for improvement.
Factors influencing the assessment of prognosis were history, clinical presentation, and response to resuscitation.Internal factors affecting decision-making were driven by emotion and contemplation.External factors affecting decision-making included family, safety, and disposition.
System challenges relating to bystander response and resources were identified.Ideas for improvement in training and support were brought forward.Conclusion: Many factors influence OHCA decision-making in the Western Cape and Free State provinces, and numerous system challenges have been identified.
The findings of this study can be used as a frame of reference for prehospital emergency care personnel and contribute to the development tenga flip orb of context-specific guidelines.