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

Abstract

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.

Akuttmedisinsk turnusarbeid i Finnmark

“…The purpose of the study was to try to obtain a better understanding of why duty doctors in the municipal health service do not always participate in emergency call-outs (9,10). Because the study is qualitative and not intended for generalisation, the findings cannot simply be transferred to other accident and emergency doctors.…”

For en bedre akuttmedisinsk tjeneste i Norge

“…Få andre studier har sett på forekomsten av akutt sykdom og skade i en befolkning i en kommune, men enkelte studier har sett på omfanget av røde responser fra AMK-sentraler. Ellensen, Wisborg, Hunskaar & Zakariassen (2014) samlet inn alle henvendelser som fikk hastegrad akutt (rød respons) fra et tidsrom på 72 timer fra alle AMK-sentraler i Norge, og fant en rød responsrate på 21 per 1000 innbyggere per år. Zakariassen, Burman & Hunskaar (2010) gjorde en tre måneders registrering av røde responser fra tre AMK-sentraler som viste en hendelsesinsidens på 25 per 1000 innbyggere per år.…”

Uticaj korišćenja protokola „Indeks urgentnog zbrinjavanja“ na procenu tegoba i hitnosti pacijenta

“…Operateri u stanjima bez svesti, u kojima bi morali da označe poziv crvenim, to ne čine u preko 50% slučajeva [5]. Operateri se očigledno ne pridržavaju uvek protokola za rad ali to je opisano i u Norveškoj [13]. To zavisi od toga da li su oni koji rade na terenu u rotaciji, tj povremeno zaposleni i na radnom mestu onih koji primaju pozive u pomoć na telefonu hitne pomoći, pa od toga zavisi i da li se neko više ili manje pridržava Index-a [13].…”

“…Operateri se očigledno ne pridržavaju uvek protokola za rad ali to je opisano i u Norveškoj [13]. To zavisi od toga da li su oni koji rade na terenu u rotaciji, tj povremeno zaposleni i na radnom mestu onih koji primaju pozive u pomoć na telefonu hitne pomoći, pa od toga zavisi i da li se neko više ili manje pridržava Index-a [13]. Veoma je teško preko telefona proceniti stanje hitnosti pacijenta.…”