Utility of Emergency Medical Dispatch (EMD) Telephone Screening in Identifying COVID-19 Positive Patients

McCann-Pineo, Molly; Li, Timmy; Barbara, Paul; Levinsky, Brian; Debono, James; Berkowitz, Jonathan

doi:10.1080/10903127.2021.1939817

Cited by 4 publications

(4 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is a balance to strike between additional workload and gain. Our study, along with those by both Pineo et al [19] and Spangler et al, [20] highlight the significant challenges services face in identifying COVID-19 using telephone and clinical triage. Importantly, these poor PPV during triage reinforce current NHS recommended enhanced PPE approaches during prehospital patient care.…”

Section: Triage Systemssupporting

confidence: 64%

“…However, this was slightly lower than in two other recently published, although smaller, studies. The first, a study by Pineo et al, [19] examined the positive predictive value of MPDS Protocol 36 in New York City, USA and determined this to be 24.3% and the second by Spangler et al, [20] a nurse led triage system in Sweden, reported a PPV of 24.7% (in tested patients). It is not known why there is a difference in PPV using the same or similar systems.…”

Section: Triage Systemsmentioning

confidence: 99%

See 1 more Smart Citation

Epidemiology of emergency ambulance service calls related to COVID-19 in Scotland: a national record linkage study

Fitzpatrick

Duncan

Moore

et al. 2022

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

Background COVID-19 has overwhelmed health services across the world; its global death toll has exceeded 5.3 million and continues to grow. There have been almost 15 million cases of COVID-19 in the UK. The need for rapid accurate identification, appropriate clinical care and decision making, remains a priority for UK ambulance service. To support identification and conveyance decisions of patients presenting with COVID-19 symptoms the Scottish Ambulance Service introduced the revised Medical Priority Dispatch System Protocol 36, enhanced physician led decision support and prehospital clinical guidelines. This study aimed to characterise the impact of these changes on the pathways and outcomes of people attended by the SAS) with potential COVID-19. Methods A retrospective record linkage cohort study using National Data collected from NHS Scotland over a 5 month period (April–August 2020). Results The SAS responded to 214,082 emergency calls during the study time period. The positive predictive value of the Protocol 36 to identify potentially COVID-19 positive patients was low (17%). Approximately 60% of those identified by Protocol 36 as potentially COVID-19 positive were conveyed. The relationship between conveyance and mortality differed between Protocol 36 Covid-19 positive calls and those that were not. In those identified by Protocol 36 as Covid-19 negative, 30 day mortality was higher in those not conveyed (not conveyed 9.2%; conveyed 6.6%) but in the Protocol 36 Covid-19 positive calls, mortality was higher in those conveyed (not conveyed 4.3% conveyed 8.8%). Thirty-day mortality rates of those with COVID-19 diagnosed through virology was between 28.8 and 30.2%. Conclusion The low positive predictive value (17%) of Protocol 36 in identifying potential COVID-19 in patients emphasises the importance of ambulance clinicians approaching each call as involving COVID-19, reinforcing the importance of adhering to existing policy and continued use of PPE at all calls. The non-conveyance rate of people that were categorised as COVID-19 negative was higher than in the preceding year in the same service. The reasons for the higher rates of non-conveyance and the relationship between non conveyance rates and death at 3 and 30 days post index call are unknown and would benefit from further study.

show abstract

Section: Triage Systemssupporting

confidence: 64%

Section: Triage Systemsmentioning

confidence: 99%

Epidemiology of emergency ambulance service calls related to COVID-19 in Scotland: a national record linkage study

Fitzpatrick

Duncan

Moore

et al. 2022

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

show abstract

“…According to their findings, initial vital signs (with the exception of body temperature) [ 82 ], prehospital triage tools [ 81 ], and telephone screening processes/surveillance tools used by emergency medical dispatchers [ 46 , 65 , 77 , 80 ] had little to moderate predictive value for the identification of COVID-19 patients and/or death.…”

Section: Resultsmentioning

confidence: 99%

Emergency medical service interventions and experiences during pandemics: A scoping review

Laparidou,

Curtis,

Wijegoonewardene

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

Background The global impact of COVID-19 has been profound, with efforts to manage and contain the virus placing increased pressure on healthcare systems and Emergency Medical Services (EMS) in particular. There has been no previous review of studies investigating EMS interventions or experiences during pandemics. The aim of this scoping review was to identify and present published quantitative and qualitative evidence of EMS pandemic interventions, and how this translates into practice. Methods Six electronic databases were searched from inception to July 2022, supplemented with internet searches and forward and backward citation tracking from included studies and review articles. A narrative synthesis of all eligible quantitative studies was performed and structured around the aims, key findings, as well as intervention type and content, where appropriate. Data from the qualitative studies were also synthesised narratively and presented thematically, according to their main aims and key findings. Results The search strategy identified a total of 22,599 citations and after removing duplicates and excluding citations based on title and abstract, and full text screening, 90 studies were included. The quantitative narrative synthesis included seven overarching themes, describing EMS pandemic preparedness plans and interventions implemented in response to pandemics. The qualitative data synthesis included five themes, detailing the EMS workers’ experiences of providing care during pandemics, their needs and their suggestions for best practices moving forward. Conclusions Despite concerns for their own and their families’ safety and the many challenges they are faced with, especially their knowledge, training, lack of appropriate Personal Protective Equipment (PPE) and constant protocol changes, EMS personnel were willing and prepared to report for duty during pandemics. Participants also made recommendations for future outbreak response, which should be taken into consideration in order for EMS to cope with the current pandemic and to better prepare to respond to any future ones. Trial registration The review protocol was registered with the Open Science Framework (osf.io/2pcy7).

show abstract

“…Previous studies demonstrate lower rates of bystander cardiopulmonary resuscitation and public AED usage, which corresponds to lower rates of sustained return of spontaneous circulation (ROSC), lower survival to hospital discharge, and in general, a higher incidence of OHCA during the COVID-19 pandemic compared to prior years [32,34]. Furthermore, EMS agencies have implemented rigorous screening protocols for potential COVID-19 symptoms or known infections in all EMS calls, and new processes have been introduced to ensure that first responders have access to appropriate personal protective equipment (PPE), thereby maximizing their safety during interventions [35,36].…”

Section: Introductionmentioning

confidence: 99%

Effect of SARS-CoV-2 infection on out-of-hospital cardiac arrest outcomes – systematic review and meta-analysis

Krawczyk¹,

Szarpak²,

Bragazzi³

et al. 2023

Ann Agric Environ Med.

View full text Add to dashboard Cite

Introduction andObjective. The COVID-19 pandemic caused by the SARS-CoV-2 virus has recently presented the world with an unprecedented challenge. The purpose of this systematic review and meta-analysis is to investigate the relationship between SARS-CoV-2 infection and out-of-hospital cardiac arrest (OHCA) by comparing data from infected and non-infected individuals. The study adds to our understanding of the broader effects of the pandemic on public health and emergency care by examining the influence of COVID-19 on OHCA. Materials and method. A comprehensive systematic literature search was performed using PubMed, EMBASE, Scopus, Web of Science, the Cochrane Library and Google Scholar from 1 January 2020 -24 May 2023. Incidence rates and odds ratios (ORs) or mean differences (MDs) with 95% confidence intervals (CIs) for risk factors were recorded from individual studies, and random-effects inverse variance modelling used to generate pooled estimates. Results. Six studies, involving 5,523 patients, met the criteria for inclusion in the meta-analysis. Survival to hospital admission, defined as admission to the emergency department with sustained return of spontaneous circulation (ROSC), among patients with and without on-going infection was 12.2% and 20.1%, respectively (p=0.09). Survival to hospital discharge/30-day survival rate was 0.8% vs. 6.2% (p<0.001). Two studies reported survival to hospital discharge in good neurological condition; however, the difference was not statistically significant (2.1% vs. 1.8%; p=0.37). Conclusions. Compared to the non-infected patients, the ongoing SARS-CoV-2 infection was associated with worse OHCA outcomes.

show abstract

Utility of Emergency Medical Dispatch (EMD) Telephone Screening in Identifying COVID-19 Positive Patients

Cited by 4 publications

References 26 publications

Epidemiology of emergency ambulance service calls related to COVID-19 in Scotland: a national record linkage study

Epidemiology of emergency ambulance service calls related to COVID-19 in Scotland: a national record linkage study

Emergency medical service interventions and experiences during pandemics: A scoping review

Effect of SARS-CoV-2 infection on out-of-hospital cardiac arrest outcomes – systematic review and meta-analysis

Contact Info

Product

Resources

About