Accuracy in identifying patients with loss of consciousness in a police‐operated emergency call centre – first step in the chain of survival

Bach, Allan; Christensen, Erika Frischknecht

doi:10.1111/j.1399-6576.2007.01310.x

Cited by 13 publications

(11 citation statements)

References 18 publications

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“…Cardiac arrest was found in only 4.9% of all patient contacts (53/1076, Figure 2 ) showing a massive overtriage of the BLS responders. This was expected as it has been described in two studies from our area: One found dispatch to acute coronary syndrome to have a positive predictive value of only 45% [ 16 ], the other a positive predictive value of only 39% when comparing persons classified as 'unconscious' in the dispatch message to the Glasgow Coma Scale-score upon arrival of the MECU at scene [ 19 ]. Emergency calls in Denmark are directed to the National Emergency Call Centre operated by the police (non-health care personnel) which may contribute to both over- and undertriage.…”

Section: Discussionmentioning

confidence: 62%

Fire fighters as basic life support responders: A study of successful implementation

Høyer

Christensen

2009

Scand J Trauma Resusc Emerg Med

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Background: First responders are recommended as a supplement to the Emergency Medical Services (EMS) in order to achieve early defibrillation. Practical and organisational aspects are essential when trying to implement new parts in the "Chain of Survival"; areas to address include minimizing dispatch time, ensuring efficient and quick communication, and choosing areas with appropriate driving distances.

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Section: Discussionmentioning

confidence: 62%

Fire fighters as basic life support responders: A study of successful implementation

Høyer

Christensen

2009

Scand J Trauma Resusc Emerg Med

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“…6 High overtriage rates have been reported in unconscious patients and cardiac emergencies. 6,7 Overtriage is not specific for dispatching centres, and it exists at all levels of emergency care. 8,9 After the end of Period II, ambulance resources had to be increased permanently because the demand remained constantly high.…”

Section: Principal Findingsmentioning

confidence: 99%

Fusion of dispatching centres into one entity: effects on performance

Määttä

Kuisma

Väyrynen

et al. 2010

Acta Anaesthesiol Scand

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“…Ten years ago, a survey of prehospital care in the Nordic countries highlighted the former police-operated system as a weak link in Danish prehospital care [ 6 ]. A statement that was stressed by studies showing moderate to low accuracy in detection of acute coronary syndrome patients and patients with loss of consciousness [ 7 , 8 ]. The Danish EMCCs assess all incoming calls using a criteria-based dispatch protocol (the Danish Index for Emergency Care), which divides patients into five levels of emergency (A–E) based on their main symptoms [ 9 - 11 ].…”

Section: Introductionmentioning

confidence: 99%

Preventable deaths following emergency medical dispatch – an audit study

Andersen

Johnsen

Hansen

et al. 2014

Scand J Trauma Resusc Emerg Med

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BackgroundCall taker triage of calls to the 112 emergency number, can be error prone because rapid decisions must be made based on limited information. Here we investigated the preventability and common characteristics of same-day deaths among patients who called 112 and were not assigned an ambulance with lights and sirens by the Emergency Medical Communication Centre (EMCC).MethodsAn audit was performed by an external panel of experienced prehospital consultant anaesthesiologists. The panel focused exclusively on the role of the EMCC, assessing whether same-day deaths among 112 callers could have been prevented if the EMCC had assessed the situations as highly urgent. The panels’ assessments were based on review of patient charts and voice-log recordings of 112 calls. All patient related material was reviewed by the audit panel and all cases where then scored as preventable, potentially preventable or non-preventable during a two day meeting. The study setting was three of five regions in Denmark with a combined population of 4,182,613 inhabitants, which equals 75% of the Danish population. The study period was 18 months, from mid-2011 to the end of 2012.ResultsLinkage of prospectively collected EMCC data with population-based registries resulted in the identification of 94,488 non-high-acuity 112 callers. Among these callers, 152 (0.16% of all) died on the same day as the corresponding 112 call, and were included in this study. The mean age of included patients was 74.4 years (range, 31–100 years) and 45.4% were female. The audit panel found no definitively preventable deaths; however, 18 (11.8%) of the analysed same-day deaths (0.02% of all non-high-acuity callers) were found to be potentially preventable. In 13 of these 18 cases, the dispatch protocol was either not used or not used correctly.ConclusionSame-day death rarely occurred among 112 callers whose situations were assessed as not highly urgent. No same-day deaths were found to be definitively preventable by a different EMCC call assessment, but a minority of same-day deaths could potentially have been prevented with more accurate triage. Better adherence with dispatch protocol could improve the safety of the dispatch process.

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Accuracy in identifying patients with loss of consciousness in a police‐operated emergency call centre – first step in the chain of survival

Abstract: The accuracy was moderate with room for improvement. The positive predictive value was low, indicating over-triage of MECU.

Cited by 13 publications

References 18 publications

Fire fighters as basic life support responders: A study of successful implementation

Fire fighters as basic life support responders: A study of successful implementation

Fusion of dispatching centres into one entity: effects on performance

Preventable deaths following emergency medical dispatch – an audit study

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