Improving the Appropriateness of Advanced Life Support Teams' Dispatch: A Before-After Study.
Emergency Medical Services
emergency medical dispatch
medical order entry systems
Journal
Prehospital and disaster medicine
ISSN: 1945-1938
Titre abrégé: Prehosp Disaster Med
Pays: United States
ID NLM: 8918173
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
pubmed:
2
2
2021
medline:
26
11
2021
entrez:
1
2
2021
Statut:
ppublish
Résumé
The dispatch of Advanced Life Support (ALS) teams in Emergency Medical Services (EMS) is still a hardly studied aspect of prehospital emergency logistics. In 2015, the dispatch algorithm of Emilia Est Emergency Operation Centre (EE-EOC) was implemented and the dispatch of ALS teams was changed from primary to secondary based on triage of dispatched vehicles for high-priority interventions when teams with Immediate Life Support (ILS) skills were dispatched. This study aimed to evaluate the effects on the appropriateness of ALS teams' intervention and their employment time, and to compare sensitivity and specificity of the algorithm implementation. This was a retrospective before-after observational study. Primary dispatches managed by EE-EOC involving ambulances and/or ALS teams were included. Two groups were created on the basis of the years of intervention (2013-2014 versus 2017-2018). A switch from primary to secondary dispatch of ALS teams in case of high-priority dispatches managed by ILS teams was implemented. Appropriateness of ALS team intervention, total task time of ALS vehicles, and sensitivity and specificity of the algorithm were reviewed. The study included 242,501 emergency calls that generated 56,567 red code dispatches. The new algorithm significantly increased global sensitivity and specificity of the system in terms of recognition of potential need of ALS intervention and the specificity of primary ALS dispatch. The appropriateness of ALS intervention was significantly increased; total tasking time per day for ALS and the number of critical dispatches without ALS available were reduced. The revision of the dispatch criteria and the extension of the two-tiered dispatch for ALS teams significantly increased the appropriateness of ALS intervention and reduced both the global tasking time and the number of high-priority dispatches without ALS teams available.
Sections du résumé
BACKGROUND AND IMPORTANCE
BACKGROUND
The dispatch of Advanced Life Support (ALS) teams in Emergency Medical Services (EMS) is still a hardly studied aspect of prehospital emergency logistics. In 2015, the dispatch algorithm of Emilia Est Emergency Operation Centre (EE-EOC) was implemented and the dispatch of ALS teams was changed from primary to secondary based on triage of dispatched vehicles for high-priority interventions when teams with Immediate Life Support (ILS) skills were dispatched.
OBJECTIVES
OBJECTIVE
This study aimed to evaluate the effects on the appropriateness of ALS teams' intervention and their employment time, and to compare sensitivity and specificity of the algorithm implementation.
DESIGN
METHODS
This was a retrospective before-after observational study.
SETTINGS AND PARTICIPANTS
METHODS
Primary dispatches managed by EE-EOC involving ambulances and/or ALS teams were included. Two groups were created on the basis of the years of intervention (2013-2014 versus 2017-2018).
INTERVENTION
METHODS
A switch from primary to secondary dispatch of ALS teams in case of high-priority dispatches managed by ILS teams was implemented.
OUTCOMES
RESULTS
Appropriateness of ALS team intervention, total task time of ALS vehicles, and sensitivity and specificity of the algorithm were reviewed.
RESULTS
RESULTS
The study included 242,501 emergency calls that generated 56,567 red code dispatches. The new algorithm significantly increased global sensitivity and specificity of the system in terms of recognition of potential need of ALS intervention and the specificity of primary ALS dispatch. The appropriateness of ALS intervention was significantly increased; total tasking time per day for ALS and the number of critical dispatches without ALS available were reduced.
CONCLUSION
CONCLUSIONS
The revision of the dispatch criteria and the extension of the two-tiered dispatch for ALS teams significantly increased the appropriateness of ALS intervention and reduced both the global tasking time and the number of high-priority dispatches without ALS teams available.
Identifiants
pubmed: 33517934
pii: S1049023X21000030
doi: 10.1017/S1049023X21000030
doi:
Types de publication
Journal Article
Observational Study
Langues
eng