Transportation-Related Injuries and Fatalities among Emergency Medical Technicans and Paramedics

Maguire, Brian J.

doi:10.1017/s1049023x11006601

Cited by 42 publications

(50 citation statements)

References 30 publications

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“…Over-triage is not harmful for the patients who benefit from it. It may however lead to an excessive use of L&S ambulances running hot for no or only little benefit for the patient [18, 19] and potentially fatal complications for the general population and EMS personnel [17, 20]. Over-triage may also lead to a scarcity of ambulances and endanger patients, as P1 dispatch will not be diverted to another suspected severe patient while P2 and P3 are very often in our system.…”

Section: Discussionmentioning

confidence: 99%

Merger of two dispatch centres: does it improve quality and patient safety?

Moser¹,

Mettler²,

Fuchs³

et al. 2017

Scand J Trauma Resusc Emerg Med

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BackgroundDispatch centres (DCs) are considered an essential but expensive component of many highly developed healthcare systems. The number of DCs in a country, region, or state is usually based on local history and often related to highly decentralised healthcare systems. Today, current technology (Global Positioning System or Internet access) abolishes the need for closeness between DCs and the population. Switzerland went from 22 DCs in 2006 to 17 today. This study describes from a quality and patient safety point of view the merger of two DCs.MethodsThe study analysed the performance (over and under-triage) of two medical DCs for 12 months prior to merging and for 12 months again after the merger in 2015. Performance was measured comparing the priority level chosen by dispatcher and the severity of cases assessed by paramedics on site using the National Advisory Committee for Aeronautics (NACA) score. We ruled that NACA score > 3 (injuries/diseases which can possibly lead to deterioration of vital signs) to 7 (lethal injuries/diseases) should require a priority dispatch with lights and siren (L&S). While NACA score < 4 should require a priority dispatch without L&S. Over-triage was defined as the proportion of L&S dispatches with a NACA score < 4, and under-triage as the proportion of dispatches without L&S with a NACA > 3.ResultsPrior to merging, Dispatch A had a sensitivity/specificity regarding the use of lights and sirens and severity of cases of 86%/48% with over- and under-triage rates of 78% and 5%, respectively. Dispatch B had sensitivity and specificity of 92%/20% and over- and under-triage rates of 84% and 7%, respectively. After they merged, global sensitivity/specificity reached 87%/67%, and over- and under-triage rates were 71% and 3%, respectivelyConclusionsA part the potential cost advantage achieved by the merger of two DCs, it can improve the quality of services to the population, reducing over- and under-triage and the use of lights and sirens and therefore, the risk of accidents. This is especially the case when a DC with poor triage performance merges with a high-performing DC.

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Section: Discussionmentioning

confidence: 99%

Merger of two dispatch centres: does it improve quality and patient safety?

Moser¹,

Mettler²,

Fuchs³

et al. 2017

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

show abstract

“…EMS workers have a documented fatality rate of 12.7 per 100,000 workers, more than twice the national average of 5.0 per 100,000 [25]. By some estimates, the risk of transportation-related injury to EMS workers and their patients may be five times the national average risk of transit injury [26]. These deaths and injuries are largely attributed to helicopter and ambulance crashes, resulting from the emphasis on shorter pre-hospital time frames [27,28].…”

Section: Negative or Inconclusive Evidence For The Golden Hourmentioning

confidence: 99%

The golden hour in trauma: Dogma or medical folklore?

Rogers

Rittenhouse

Gross

2015

Injury

139

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“…A growing body of research shows that EMS personnel have a high level of occupational risks including a fatality rate comparable to police and firefighters and non‐fatal injury rates similar to and above the rates for police and firefighters . There is also evidence that violence against EMS personnel contributes to their occupational injury risks .…”

Section: Introductionmentioning

confidence: 99%