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Does the Norwegian emergency medical dispatch classification as non-urgent predict no need for pre-hospital medical treatment? An observational study
BACKGROUND: The number of ambulance call-outs in Norway is increasing owing to societal changes and increased demand from the public. Together with improved but more expensive education of ambulance staff, this leads to increased costs and staffing shortages. We wanted to study whether the current d...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4859986/ https://www.ncbi.nlm.nih.gov/pubmed/27154472 http://dx.doi.org/10.1186/s13049-016-0258-8 |
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author | Grusd, Eystein Kramer-Johansen, Jo |
author_facet | Grusd, Eystein Kramer-Johansen, Jo |
author_sort | Grusd, Eystein |
collection | PubMed |
description | BACKGROUND: The number of ambulance call-outs in Norway is increasing owing to societal changes and increased demand from the public. Together with improved but more expensive education of ambulance staff, this leads to increased costs and staffing shortages. We wanted to study whether the current dispatch triage tools could reliably identify patients who only required transport, and not pre-hospital medical care. This could allow selection of such patients for designated transport units, freeing up highly trained ambulance staff to attend patients in greater need. METHODS: A cross-sectional observational study was used, drawing on all electronic and paper records in our ambulance service from four random days in 2012. The patients were classified into acuity groups, based on Emergency Medical Dispatch codes, and pre-hospital interventions were extracted from the Patient Report Forms. RESULTS: Of the 1489 ambulance call-outs included in this study, 82 PRFs (5 %) were missing. A highly significant association was found between acuity group and recorded pre-hospital intervention (p ≤ 0.001). We found no correlation between gender, distance to hospital, age and pre-hospital interventions. Ambulances staffed by paramedics performed more interventions (234/917, 26 %) than those with emergency medical technicians (42/282, 15 %). The strongest predictor for needing pre-hospital interventions was found to be the emergency medical dispatch acuity descriptor. DISCUSSION: This study has demonstrated that the Norwegian dispatch system is able to correctly identify patients who do not need pre-hospital interventions. Patients with a low acuity code had a very low level of pre-hospital interventions. Evaluation of adherence to protocol in the Emergency Medical Dispatch is not possible due to the inherent need for medical experience in the triage process. CONCLUSIONS: This study validates the Norwegian dispatch tool (Norwegian index) as a predictor of patients who do not need pre-hospital interventions. |
format | Online Article Text |
id | pubmed-4859986 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-48599862016-05-08 Does the Norwegian emergency medical dispatch classification as non-urgent predict no need for pre-hospital medical treatment? An observational study Grusd, Eystein Kramer-Johansen, Jo Scand J Trauma Resusc Emerg Med Original Research BACKGROUND: The number of ambulance call-outs in Norway is increasing owing to societal changes and increased demand from the public. Together with improved but more expensive education of ambulance staff, this leads to increased costs and staffing shortages. We wanted to study whether the current dispatch triage tools could reliably identify patients who only required transport, and not pre-hospital medical care. This could allow selection of such patients for designated transport units, freeing up highly trained ambulance staff to attend patients in greater need. METHODS: A cross-sectional observational study was used, drawing on all electronic and paper records in our ambulance service from four random days in 2012. The patients were classified into acuity groups, based on Emergency Medical Dispatch codes, and pre-hospital interventions were extracted from the Patient Report Forms. RESULTS: Of the 1489 ambulance call-outs included in this study, 82 PRFs (5 %) were missing. A highly significant association was found between acuity group and recorded pre-hospital intervention (p ≤ 0.001). We found no correlation between gender, distance to hospital, age and pre-hospital interventions. Ambulances staffed by paramedics performed more interventions (234/917, 26 %) than those with emergency medical technicians (42/282, 15 %). The strongest predictor for needing pre-hospital interventions was found to be the emergency medical dispatch acuity descriptor. DISCUSSION: This study has demonstrated that the Norwegian dispatch system is able to correctly identify patients who do not need pre-hospital interventions. Patients with a low acuity code had a very low level of pre-hospital interventions. Evaluation of adherence to protocol in the Emergency Medical Dispatch is not possible due to the inherent need for medical experience in the triage process. CONCLUSIONS: This study validates the Norwegian dispatch tool (Norwegian index) as a predictor of patients who do not need pre-hospital interventions. BioMed Central 2016-05-06 /pmc/articles/PMC4859986/ /pubmed/27154472 http://dx.doi.org/10.1186/s13049-016-0258-8 Text en © Grusd and Kramer-Johansen. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Original Research Grusd, Eystein Kramer-Johansen, Jo Does the Norwegian emergency medical dispatch classification as non-urgent predict no need for pre-hospital medical treatment? An observational study |
title | Does the Norwegian emergency medical dispatch classification as non-urgent predict no need for pre-hospital medical treatment? An observational study |
title_full | Does the Norwegian emergency medical dispatch classification as non-urgent predict no need for pre-hospital medical treatment? An observational study |
title_fullStr | Does the Norwegian emergency medical dispatch classification as non-urgent predict no need for pre-hospital medical treatment? An observational study |
title_full_unstemmed | Does the Norwegian emergency medical dispatch classification as non-urgent predict no need for pre-hospital medical treatment? An observational study |
title_short | Does the Norwegian emergency medical dispatch classification as non-urgent predict no need for pre-hospital medical treatment? An observational study |
title_sort | does the norwegian emergency medical dispatch classification as non-urgent predict no need for pre-hospital medical treatment? an observational study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4859986/ https://www.ncbi.nlm.nih.gov/pubmed/27154472 http://dx.doi.org/10.1186/s13049-016-0258-8 |
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