EMS dispatch

Clawson, Jeff

doi:10.1002/9781118990810.ch84

Cited by 16 publications

(18 citation statements)

References 25 publications

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“…Sporer et al reported on an MPD system that uses slightly different main symptom groups; nevertheless, the small proportion of unclear problems and the high proportion of breathing problems stands out compared to our results. Other studies of MPD systems have typically reported unclear problems in 5–8% of patients [12,13] The fixed algorithm structure of the MPDS may explain some of the difference in the proportion of breathing problems. In Denmark all citizens have 24 hr access to a general practioner, which may also explain some of the differences.…”

Section: Discussionmentioning

confidence: 99%

Implementing a nationwide criteria-based emergency medical dispatch system: A register-based follow-up study

Andersen

Johnsen

Sørensen

et al. 2013

Scand J Trauma Resusc Emerg Med

139

141

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BackgroundA criteria-based nationwide Emergency Medical Dispatch (EMD) system was recently implemented in Denmark. We described the system and studied its ability to triage patients according to the severity of their condition by analysing hospital admission and case-fatality risks.MethodsThis was a register-based follow-up study of all 1-1-2 calls in a 6-month period that were triaged according to the Danish Index – the new criteria-based dispatch protocol. Danish Index data were linked with hospital and vital status data from national registries. Confidence intervals (95%) for proportions with binomial data were computed using exact methods. To test for trend the Wald test was used.ResultsInformation on level of emergency according to the Danish Index rating was available for 67,135 patients who received ambulance service. Emergency level A (urgent cases) accounted for 51.4% (n = 34,489) of patients, emergency level B for 46.3% (n = 31,116), emergency level C for 2.1% (n = 1,391) and emergency level D for 0.2% (n = 139). For emergency level A, the median time from call receipt to ambulance dispatch was 2 min 1 s, and the median time to arrival was 6 min 11 s. Data concerning admission and case fatality was available for 55,270 patients. The hospital admission risk for emergency level A patients was 64.4% (95% CI = 63.8-64.9). There was a significant trend (p < 0.001) towards lower admission risks for patients with lower levels of emergency. The case fatality risk for emergency level A patients on the same day as the 1-1-2 call was 4.4% (95% CI = 4.1-4.6). The relative case-fatality risk among emergency level A patients compared to emergency level B–D patients was 14.3 (95% CI: 11.5-18.0).ConclusionThe majority of patients were assessed as Danish Index emergency level A or B. Case fatality and hospital admission risks were substantially higher for emergency level A patients than for emergency level B–D patients. Thus, the newly implemented Danish criteria-based dispatch system seems to triage patients with high risk of admission and death to the highest level of emergency. Further studies are needed to determine the degree of over- and undertriage and prognostic factors.

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Section: Discussionmentioning

confidence: 99%

Implementing a nationwide criteria-based emergency medical dispatch system: A register-based follow-up study

Andersen

Johnsen

Sørensen

et al. 2013

Scand J Trauma Resusc Emerg Med

139

141

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“…Many EMS agencies, including the agency studied, utilize the Medical Priority Dispatch System that encompasses a set of 32 codes to determine the acuity and priority of a call. 27 Apnea and shortness of breath are signs a person is dying that are closely related to difficulty breathing/breathing problems, which is a common dispatch code and one for which prehospital providers are taught time-critical interventions. Only one of the symptoms presented on the survey (breathing difficulty) is also one of these codes.…”

Section: Discussionmentioning

confidence: 99%

Prehospital Providers’ Perceptions of Emergency Calls Near Life’s End

Waldrop

Clemency

Maguin

et al. 2014

Am J Hosp Palliat Care

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The nature of emergency end-of-life calls is changing as people live longer and die from chronic illnesses. This study explored prehospital providers' perceptions of (1) end-of-life 911 calls, (2) the signs and symptoms of dying, and (3) medical orders for life sustaining treatment (MOLST). The exploratory-descriptive pilot study was survey based and cross-sectional. Calls to nursing homes occur most often, (47.8% every shift). The MOLST was seen infrequently (57.9% rarely never). The most frequent signs and symptoms of dying were diagnosis (76%), hospice involvement (82%), apnea (75%), mottling (55%), and shortness of breath (48%). The MOLST identifies wishes about intubation (74%), resuscitation (74%), life-sustaining treatment (72%), and cardiopulmonary resuscitation (70%). Synergy exists between the fields of prehospital, hospice, and palliative medicine which offers potential for improved education and care.

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“…Die National Association of EMS Physicians empfiehlt seit 1989 die Nutzung und Anwendung von Protokollen zur Entscheidungsfindung. „… the EMD (emergency medical dispatcher) should follow a structured, predetermined interrogation process to activate preprogrammed response modes and provide medical instructions to caller prior to EMS arrival“ ([ 3 ]; deutsche Übersetzung: „… der Notrufexperte sollte ein strukturiertes, vorbestimmtes Abfrageschema befolgen, um vorprogrammierte Antwortmodi zu aktivieren und dem Anrufer vor Eintreffen des Rettungsdiensts medizinische Anweisungen geben zu können“).…”

Section: Standardisiertes Notrufgesprächunclassified

“…Die Protokolle geben für verschiedene Situationen vor, welche Fragen wie genau zu stellen sind und was weiter zu tun ist. Der Notrufexperte muss sich dabei an die Protokollvorgaben halten: „… a protocol says you shall, while a guideline says you may if you want … on the other hand, a guideline does not require compliance …“ ([ 3 ]; deutsche Übersetzung: „… ein Protokoll sagt, dass man soll. Eine Leitlinie dagegen sagt, dass man kann, wenn man möchte … andererseits verlangt eine Leitlinie keine Befolgung …“).…”

Section: Telefonreanimationunclassified

Strukturierte bzw. standardisierte Notrufabfrage

Mayr

2020

Notfall Rettungsmed

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Hintergrund Die zunehmende Einführung von standardisierten Notrufabfragesystemen im deutschsprachigen Raum folgt den Empfehlungen des European Resuscitation Council (ERC) und German Resuscitation Council (GRC), wonach die Notfallmeldung anhand vorgegebener Protokolle abgefragt werden soll. Obwohl in Bezug auf das Erkennen spezieller Krankheitsbilder durchaus Verbesserungsbedarf hinsichtlich Sensitivität und Spezifität bestehen kann, stellen standardisierte Produkte das Mittel der Wahl zur Notrufabfrage dar, da sie unabhängig von Nutzer, Uhrzeit und Tagesform eine gleichbleibende Anrufbearbeitung ermöglichen können. Dies erhöht die Patientensicherheit ebenso wie die Rechtssicherheit der Leitstellenmitarbeiter und der Unternehmensführung. Fragestellung Leisten Systeme der standardisierten Notrufabfrage tatsächlich das, was sie vorgeben zu leisten? Methode Recherche aktueller Literatur und Studien Ergebnis Grundsätzlich leisten die Produkte das, was sie versprechen zu leisten. Die Qualität hängt maßgeblich von der Compliance der Notrufexperten und den definierten Standards zur Anwendung ab. Schlussfolgerung Optimierungsbedarf besteht vor allem in der Erstellung von Standards zur Anwendung von Abfragesystemen und in der Ausbildung der Mitarbeiter.

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EMS dispatch

Cited by 16 publications

References 25 publications

Implementing a nationwide criteria-based emergency medical dispatch system: A register-based follow-up study

Implementing a nationwide criteria-based emergency medical dispatch system: A register-based follow-up study

Prehospital Providers’ Perceptions of Emergency Calls Near Life’s End

Strukturierte bzw. standardisierte Notrufabfrage

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