Can First Responders Be Sent to Selected 9-1-1 Emergency Medical Services Calls without an Ambulance?

Abstract

Objectives: To evaluate the feasibility and safety of initially dispatching only first responders (FRs) to selected low-risk 9-1-1 requests for emergency medical services. First responders are rapidly-responding fire crews on apparatus without transport capabilities, with firefighters trained to at least a FR level and in most cases to the basic emergency medical technician (EMT) level. Low-risk 9-1-1 requests include automatic medical alerts (ALERTs), motor vehicle incidents (MVIs) for which the caller was unable to answer any medical dispatch questions designed to prioritize the call, and 9-1-1 call disconnects (D/Cs). Methods: A beforeand-after study of patient dispositions was conducted using historical controls for comparison. During the historical control phase of six months, one year prior to the study phase, basic life support ambulances (staffed with two basic EMTs) were dispatched to selected low-risk 9-1-1 incidents. During the six-month study phase, a fire FR crew equipped with automated external defibrillators (AEDs) was sent initially without an ambulance to these incidents. Results: For ALERTs (n ¼ 290 in historical group vs. 330 in study group), there was no statistical difference in the transport rate (7% vs 10%), but there was a statistically significant increase in the follow-up use of advanced life support (ALS) (1% vs 4%, p ¼ 0.009). No patient in the ALERTs historical

Characteristics of non-conveyance ambulance runs: A retrospective study in the Netherlands

“…Emergency medical services (EMS) have developed from conveyance facilities into providers of advanced pre-hospital care. [1,2] Alongside this development there is a growing demand for EMS care, and the number of ambulance deployments is increasing. [3,4] Suggested reasons for this growing demand are changes in social support of people, accessibility of healthcare and social facilities, and the aging population.…”

Do Emergency Medical System Response Times Matter for Health Outcomes?

“…Response time was defined as the difference between the time that the ambulance is dispatched and the time that the ambulance arrives at the scene (Scott et al, 1978;Stueven et al, 1989;Cummins et al, 1991;Grossman et al, 1997;Athey and Stern, 1998;Key et al, 2003;Lerner et al, 2003). The measure of distance to the closest EMS agency was constructed by calculating the straight line distance from the incident location to the agency address of the closest provider in the territory in which the incident occurred.…”

Predictability of the Call Triage Protocol to Detect if Dispatchers Should Activate Community First Responders

“…Eventually, the response time by CFRs who are the neighbors living near the site will be the fastest responders. Community First Responder protocols are expected to contribute to increased resuscitation rates 17 , 18 …”

“…Community First Responder protocols are expected to contribute to increased resuscitation rates. 17,18 Limitations Community First Responder protocol Ver.1 was activated once under triage. This is because altered level of consciousness (ALOC) patients are hard to determine from an incoming call.…”