“Like a rainy weather inside of me”: Qualitative content analysis of telephone consultations concerning back pain preceding out-of-hospital cardiac arrest

ElsevierVolume 64, September 2022, 101200International Emergency NursingHighlights•

Back pain early warning sign preceding out-of-hospital cardiac arrest is experienced in variety of ways both in relation to location as well as complex descriptions.

The professional call-taker must be aware that patients are not trained health professionals, that can communicate according to the health system’s own logic.

Following this, call-takers should perhaps be trained to disregard the immediate diagnostic conclusions made by the patient.

AbstractIntroduction

Cardiac arrest patients presenting with back pain are at risk of not receiving the appropriate help when calling emergency medical services. In telephone consultations regarding patients with back pain preceding an out-of-hospital cardiac arrest, we investigated how communication between caller and call-taker influenced the call-taker’s interpretation of back pain descriptions and decision-making about choice of response.

Method

The study was conducted using 20 recorded phone calls from 17 patients who contacted the Copenhagen Emergency Medical Services (Denmark) reporting back pain up to 24 hours before an out-of-hospital cardiac arrest. Qualitative content analysis was applied.

Results

Two main categories emerged: (1) reasons, including subcategories: reported conditions, descriptions of conditions, patient’s interpretation of condition and patient’s own remedial actions; and (2) considerations, including subcategories: assessment of the severity, call-taker’s interpretation of the condition, arguments for chosen response and conditions not facilitating further communication by the call-taker.

Conclusion

In telephone consultations regarding patients with back pain preceding an out-of-hospital cardiac arrest the communication was influenced by the communicative preconditions of the call-taker. Communication in consultations where ambulances were not dispatched was characterized by complex descriptions of symptoms not easily fitting into the health system’s interpretations of conditions warranting an urgent response.

Keywords

Out-of-hospital cardiac arrest

Back pain

Early warning signs

Symptoms

Emergency medical services

Communication

Qualitative content analysis

Systems theory

© 2022 The Authors. Published by Elsevier Ltd.

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