Handling of drug-related emergencies: an evaluation of emergency medical dispatch

Lorem, Tonje; Elisabeth, Saether; Wik, L.

doi:10.1097/mej.0b013e3283036e47

Cited by 6 publications

(11 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our result of approximately 75% use of Index lies between the divergent findings from the 2005 study, with 99% self-reported Index guideline adherence and 64% adherence based on log-recordings [11]. To our knowledge there are no other studies addressing adherence to criteria based guidelines.…”

Section: Discussionmentioning

confidence: 68%

“…A recent systematic review on adherence to guidelines and protocols in the pre-hospital setting was not able to identify any eligible study in the emergency medical dispatch setting, neither CBD nor MPDS based [10]. However, a Norwegian study from 2005 evaluated dispatch in drug-related emergencies, and found an Index adherence of 99% based on multiple choice questionnaire, but only 64% guideline adherence based on log recordings [11]. …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Variations in contact patterns and dispatch guideline adherence between Norwegian emergency medical communication centres - a cross-sectional study

Ellensen

Hunskaar

Wisborg

et al. 2014

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

BackgroundThe 19 Norwegian Emergency medical communication centres (EMCCs) use Norwegian Index for medical emergency assistance (Index) as dispatch guidelines. Little is known about the use of Index, nor its validity. We aimed to document the epidemiology of contacts made to the public emergency medical phone number and the operators’ self-reported use of Index as a first step towards a validation study.MethodsWe registered all medical emergency calls to the EMCCs during a 72 h period in a national cross sectional study. We subsequently sent a questionnaire to all EMCC operators in Norway, asking how they use Index. A combined outcome variable “use of Index” was computed through a Likert scale, range 1–5. Regression models were used to examine factors influencing use.Results2 298 contacts were included. National contact rate was 56/1 000 inhabitants per year, range between EMCCs 34 – 119. Acute contact (life-threatening situations) rate was 21/1 000 per year, range between EMCCs 5 – 31. Index criteria 6 – ’Unresolved problem’ accounts for 20% of the 113 contacts, range between EMCCs 10 – 42%. The mean use of Index was 3.95 (SD 0.39), corresponding to “more than 75% of emergency calls”. There were differences in use of Index on EMCC level, range 3.7 – 4.4, and a multi regression model explained 23.4% of the variation in use. Operators working rotation with ground ambulance services reported reduced use of Index compared to operators not working in rotation, while distinct EMCC focus on Index increased use of Index compared to EMCCs with no focus on Index. Use of electronic records and operators experience were the main reasons given for not using Index.ConclusionsThere is a large variation between the EMCCs with regard to both contact patterns and use of Index. There is a relatively high overall self-reported use of Index by the operators, with variations on both individual and EMCC level.

show abstract

Section: Discussionmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Variations in contact patterns and dispatch guideline adherence between Norwegian emergency medical communication centres - a cross-sectional study

Ellensen

Hunskaar

Wisborg

et al. 2014

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

show abstract

“…This result is congruent with the study of Bång et al where the EMD asked only 41 percent of the callers if the patient was breathing normally [ 11 ]. Previous studies describe protocol compliance as an important factor for successfully triaging in the EMCC [ 3 , 6 ]. In our study, there were some cases where although the RN followed the assessment protocol and ascertained whether the patient was breathing and/or conscious, nevertheless, the RN did not treat the call as a high priority case.…”

Section: Discussionmentioning

confidence: 99%

“…Early identification of the patient’s symptoms result in a better outcome for out- of-hospital cardiac arrest patients [ 3 ], and theoretically early identification may be important in other medical emergencies such as myocardial infarction [ 4 ] or stroke [ 5 ]. Previous studies have described the complexity of assessing an emergency call [ 3 , 6 , 7 ]. There are also studies identifying possible reasons for not identifying the caller’s need of care; language barriers [ 8 - 10 ] unnecessary questions asked by the EMD during the call [ 11 ], and lack of information from the caller [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Barriers and opportunities in assessing calls to emergency medical communication centre - a qualitative study

Lindström

Heikkilä

Bohm

et al. 2014

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

IntroductionPrevious studies have described the difficulties and the complexity of assessing an emergency call, and assessment protocols intended to support the emergency medical dispatcher’s (EMD) assessment have been developed and evaluated in recent years. At present, the EMD identifies about 50-70 % of patients suffering from cardiac arrest, acute myocardial infarction or stroke. The previous research has primarily been focused on specific conditions, and it is still unclear whether there are any overall factors that may influence the assessment of the call to the emergency medical communication centre (EMCC).AimThe aim of the study was to identify overall factors influencing the registered nurses’ (RNs) assessment of calls to the EMCC.MethodA qualitative study design was used; a purposeful selection of calls to the EMCC was analysed by content analysis.ResultsOne hundred calls to the EMCC were analysed. Barriers and opportunities related to the RN or the caller were identified as the main factors influencing the RN’s assessment of calls to the EMCC. The opportunities appeared in the callers’ symptom description and the communication strategies used by the RN. The barriers appeared in callers’ descriptions of unclear symptoms, paradoxes and the RN’s lack of communication strategies during the call.ConclusionBarriers in assessing the call to the EMCC were associated with contradictory information, the absence of a primary problem, or the structure of the call. Opportunities were associated with a clear symptom description that was also repeated, and the RN’s use of different communication strategies such as closed loop communication.

show abstract

“…The implementation of such standardized protocols for the assessment of the patient's health status is reported to increase the detection of health impairments by emergency medical dispatchers and thus to improve the treatment [30][31][32]. Furthermore, the dispatchers should have suitable opportunities for coping with their emotions and exchanging their feelings and impressions at regular intervals to reduce their observed chronic stress level.…”

Section: Discussionmentioning

confidence: 99%

Job-related stress and work ability of dispatchers in a metropolitan fire department

Oldenburg

Wilken

Wegner

et al. 2014

J Occup Med Toxicol

View full text Add to dashboard Cite

Background: Our aim was to assess psychomental stress and strain among dispatchers in fire departments, particularly during emergency instructions by phone and to evaluate their work ability. Methods: 27 dispatchers and 20 controls were examined. In a protocol, participants recorded 1. phone instructions causing mental stress (event) 2. working time without phone instructions (non-event) 3. breaks. Continuous heart rate (variability), urine catecholamine, salivary cortisol and lymphocytes were measured. To assess the job-related burden, the Work Ability Index (WAI) was applied. Results: Dispatchers demonstrated significantly higher heart rates and reduced standard deviation of all NN (heartbeat-to-heartbeat) intervals (SDNN) than the controls in all phases. WAI of dispatchers was significantly lower than that of the controls. Within the dispatchers, there was a significantly higher rate of inability to work during the past year. Conclusions: The increased heart rate and reduced SDNN of examined dispatchers indicate chronic stress effects as a possible preliminary stage of a health disorder. In respect of the reduced work ability among dispatchers preventive measures are required to reduce the stress situation during their job-performance.

show abstract

Handling of drug-related emergencies: an evaluation of emergency medical dispatch

Abstract: On the basis of the interviews and the survey, cases were handled according to guidelines. The log recordings, however, disclosed deviation from the protocol. Alcohol intoxication was associated with higher rate of deviation from the protocol compared with other intoxications.

Cited by 6 publications

References 20 publications

Variations in contact patterns and dispatch guideline adherence between Norwegian emergency medical communication centres - a cross-sectional study

Variations in contact patterns and dispatch guideline adherence between Norwegian emergency medical communication centres - a cross-sectional study

Barriers and opportunities in assessing calls to emergency medical communication centre - a qualitative study

Job-related stress and work ability of dispatchers in a metropolitan fire department

Contact Info

Product

Resources

About