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Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2018

Open Access 01-12-2018 | Review

The accuracy of medical dispatch - a systematic review

Authors: K. Bohm, L. Kurland

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2018

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Abstract

Background

It is a challenge to dispatch Emergency medical Services (EMS) appropriately with limited resources and maintaining patient safety; this requires accurate dispatching systems. The objective of the current systematic review was to examine the evidence, according to GRADE, for medical dispatching systems to accurately dispatch EMS according to level of acuity and in recognition of specific conditions.
A systematic search was performed trough PubMed, Web of Science, Embase (free text in all fields), Centre for Reviews and Dissemination (CRD), and Cochrane Central Register of Controlled Trials up to 16th of May, 2017. A combination of keywords and Medical Subject Heading (MeSH) terms relevant to “emergency medical dispatch criteria” were used, to search for articles published between 2012 and 2017. Publications were included according to the inclusion/exclusion criteria using the Systematic Reviews and Meta-Analyses (PRISMA) protocol. Level of evidence was evaluated in accordance with Grading of Recommendations Assessment, Development and Evaluation (GRADE). Articles included were those that provided evidence for at least one of the measures of dispatch system accuracy; i.e. sensitivity, specificity, positive and negative predictive and/or over- and under-triage. The search identified 1445 articles. After the removal of duplicates, 382 titles were reviewed for relevance and an additional 359 articles were excluded based on manuscript title and abstract. An additional five articles were excluded after review of the full text versions of the remaining articles. The current review included 18 publications which all were based on primary research.

Conclusions

The 18 articles addressed the identification of cardiac arrest, stroke, medical priority and major trauma using different dispatching systems. The results of the current review show that there is a very low to low overall level of evidence for the accuracy of medical dispatching systems. We suggest that it is necessary to create a consensus on common standards for reporting before consensus can be reached for the level of accuracy in medical dispatching systems.
Literature
1.
go back to reference Snooks H, Evans A, Wells B, Peconi J, Thomas M, Woolard M, et al. What are the highest priorities for research in emergency prehospital care? Emerg Med J. 2009;26:549–50.CrossRef Snooks H, Evans A, Wells B, Peconi J, Thomas M, Woolard M, et al. What are the highest priorities for research in emergency prehospital care? Emerg Med J. 2009;26:549–50.CrossRef
3.
go back to reference Sporer KA, Johnson NJ, Yeh CC, Youngblood GM. Can emergency medical dispatch codes predict prehospital interventions for common 9-1-1 call types? Prehosp Emerg Care. 2008;12(4):470–8.CrossRef Sporer KA, Johnson NJ, Yeh CC, Youngblood GM. Can emergency medical dispatch codes predict prehospital interventions for common 9-1-1 call types? Prehosp Emerg Care. 2008;12(4):470–8.CrossRef
4.
go back to reference Andersen MS, Johnsen SP, Sörensen JN, Jepsen SB, Hansen JB, Christensen EF. Implementing a nationwide criteria-based emergency medical dispatch system: a register based follow-up study. Scand J Trauma Resusc Emerg Med. 2013;21:53.CrossRef Andersen MS, Johnsen SP, Sörensen JN, Jepsen SB, Hansen JB, Christensen EF. Implementing a nationwide criteria-based emergency medical dispatch system: a register based follow-up study. Scand J Trauma Resusc Emerg Med. 2013;21:53.CrossRef
5.
go back to reference Stipulante S, Tubes R, El Fassi M, Donneau AF, Van Troyen B, Hartstein G, et al. Implemention of the ALERT-algorithm, a new dispatcher-assisted cardio pulmonary resuscitation protocol, in non-advanced medical priority dispatch system (AMPDS) emergency medical services centres. Resuscitation. 2014;85:177–81.CrossRef Stipulante S, Tubes R, El Fassi M, Donneau AF, Van Troyen B, Hartstein G, et al. Implemention of the ALERT-algorithm, a new dispatcher-assisted cardio pulmonary resuscitation protocol, in non-advanced medical priority dispatch system (AMPDS) emergency medical services centres. Resuscitation. 2014;85:177–81.CrossRef
6.
go back to reference Press W, Teukolsky S, Vetterling W, Flannery B. Modeling of data. Numerical recipes 3rd edition: the art of scientific computing, vol. 812. Cambridge, UK: Cambridge University Press; 2007. Press W, Teukolsky S, Vetterling W, Flannery B. Modeling of data. Numerical recipes 3rd edition: the art of scientific computing, vol. 812. Cambridge, UK: Cambridge University Press; 2007.
7.
go back to reference American College of Surgeons-COT. Resources for optimal care of injured patient. Chicago: American college of surgions-COT; 2006. American College of Surgeons-COT. Resources for optimal care of injured patient. Chicago: American college of surgions-COT; 2006.
8.
go back to reference Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preffered reporting items for systematic reviews and meta-analyses: the PRISMA statement. Br Med J. 2009;339:b2535.CrossRef Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preffered reporting items for systematic reviews and meta-analyses: the PRISMA statement. Br Med J. 2009;339:b2535.CrossRef
9.
go back to reference Guyatt GH, Oxman AD, Visit GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. Br Med J. 2008;336:924–6.CrossRef Guyatt GH, Oxman AD, Visit GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. Br Med J. 2008;336:924–6.CrossRef
11.
go back to reference Fleiss JL, Cohen J, Everitt BS. Large sample standard errors of kappa and weighted kappa. Psychol Bull. 1969;72:323–7.CrossRef Fleiss JL, Cohen J, Everitt BS. Large sample standard errors of kappa and weighted kappa. Psychol Bull. 1969;72:323–7.CrossRef
12.
go back to reference Landis JR. The measurement of observer agreement for categorical data. In: Koch GG, editor. Biometrics. Raleigh, North Carolina: The Biometric Society; 1977. Landis JR. The measurement of observer agreement for categorical data. In: Koch GG, editor. Biometrics. Raleigh, North Carolina: The Biometric Society; 1977.
13.
go back to reference Dami F, Golay C, Pasquier M, Fuchs V, Carron PN, Hugli O. Prehospital triage accuracy in a criteria based dispatch Centre. BMC Emerg Med. 2015;15:32.CrossRef Dami F, Golay C, Pasquier M, Fuchs V, Carron PN, Hugli O. Prehospital triage accuracy in a criteria based dispatch Centre. BMC Emerg Med. 2015;15:32.CrossRef
14.
go back to reference Moser A, Mettler A, Fuchs V, Hanhart W, Robert CF, Della Santa V, et al. Merger of two dispatch centres: does it improve quality and patient safety? Scand J Trauma Resusc Emerg Med. 2017;25(1):40.CrossRef Moser A, Mettler A, Fuchs V, Hanhart W, Robert CF, Della Santa V, et al. Merger of two dispatch centres: does it improve quality and patient safety? Scand J Trauma Resusc Emerg Med. 2017;25(1):40.CrossRef
15.
go back to reference Giannakopoulos GF, Bloemers FW, Lubbers WD, Christiaans HM, van Exter P, de Lange-de Klerk ES, et al. Criteria for cancelling helicopter emergency medical services (HEMS) dispatches. Emerg Med J. 2012;29(7):582–6.CrossRef Giannakopoulos GF, Bloemers FW, Lubbers WD, Christiaans HM, van Exter P, de Lange-de Klerk ES, et al. Criteria for cancelling helicopter emergency medical services (HEMS) dispatches. Emerg Med J. 2012;29(7):582–6.CrossRef
16.
go back to reference Vaillancourt C, Charette M, Kasaboski A, Hoad M, Larocque V, Crete D, et al. Cardiac arrest diagnostic accuracy of 9-1-1 dispatchers: a prospective multi-center study. Resuscitation. 2015;90:116–20.CrossRef Vaillancourt C, Charette M, Kasaboski A, Hoad M, Larocque V, Crete D, et al. Cardiac arrest diagnostic accuracy of 9-1-1 dispatchers: a prospective multi-center study. Resuscitation. 2015;90:116–20.CrossRef
17.
go back to reference Deakin CD, England S, Diffey D. Ambulance telephone triage using ‘NHS Pathways’ to identify adult cardiac arrest. Heart. 2017;103(10):761–5.CrossRef Deakin CD, England S, Diffey D. Ambulance telephone triage using ‘NHS Pathways’ to identify adult cardiac arrest. Heart. 2017;103(10):761–5.CrossRef
18.
go back to reference Moller TP, Andrell C, Viereck S, Todorova L, Friberg H, Lippert FK. Recognition of out-of-hospital cardiac arrest by medical dispatchers in emergency medical dispatch centres in two countries. Resuscitation. 2016;109:1–8.CrossRef Moller TP, Andrell C, Viereck S, Todorova L, Friberg H, Lippert FK. Recognition of out-of-hospital cardiac arrest by medical dispatchers in emergency medical dispatch centres in two countries. Resuscitation. 2016;109:1–8.CrossRef
19.
go back to reference Fukushima H, Imanishi M, Iwami T, Kitaoka H, Asai H, Seki T, et al. Implementation of a dispatch-instruction protocol for cardiopulmonary resuscitation according to various abnormal breathing patterns: a population-based study. Scand J Trauma Resusc Emerg Med. 2015;23:64.CrossRef Fukushima H, Imanishi M, Iwami T, Kitaoka H, Asai H, Seki T, et al. Implementation of a dispatch-instruction protocol for cardiopulmonary resuscitation according to various abnormal breathing patterns: a population-based study. Scand J Trauma Resusc Emerg Med. 2015;23:64.CrossRef
20.
go back to reference Tanaka Y, Nishi T, Takase K, Yoshita Y, Wato Y, Taniguchi J, et al. Survey of a protocol to increase appropriate implementation of dispatcher-assisted cardiopulmonary resuscitation for out-of-hospital cardiac arrest. Circulation. 2014;129(17):1751–60.CrossRef Tanaka Y, Nishi T, Takase K, Yoshita Y, Wato Y, Taniguchi J, et al. Survey of a protocol to increase appropriate implementation of dispatcher-assisted cardiopulmonary resuscitation for out-of-hospital cardiac arrest. Circulation. 2014;129(17):1751–60.CrossRef
21.
go back to reference Gellerstedt M, Rawshani N, Herlitz J, Bang A, Gelang C, Andersson JO, et al. Could prioritisation by emergency medicine dispatchers be improved by using computer-based decision support? A cohort of patients with chest pain. Int J Cardiol. 2016;220:734–8.CrossRef Gellerstedt M, Rawshani N, Herlitz J, Bang A, Gelang C, Andersson JO, et al. Could prioritisation by emergency medicine dispatchers be improved by using computer-based decision support? A cohort of patients with chest pain. Int J Cardiol. 2016;220:734–8.CrossRef
22.
go back to reference Dami F, Emeryb A, Pasquierb M, Carronb P-N, Fuchsa V, et al. Proposition and operational characteristics of a new dispatch scale to specifically identify acute strokes. Eur J Emerg Med. 2017;24:202–7.CrossRef Dami F, Emeryb A, Pasquierb M, Carronb P-N, Fuchsa V, et al. Proposition and operational characteristics of a new dispatch scale to specifically identify acute strokes. Eur J Emerg Med. 2017;24:202–7.CrossRef
23.
go back to reference Viereck S, Moller TP, Iversen HK, Christensen H, Lippert F. Medical dispatchers recognise substantial amount of acute stroke during emergency calls. Scand J Trauma Resusc Emerg Med. 2016;24:89.CrossRef Viereck S, Moller TP, Iversen HK, Christensen H, Lippert F. Medical dispatchers recognise substantial amount of acute stroke during emergency calls. Scand J Trauma Resusc Emerg Med. 2016;24:89.CrossRef
24.
go back to reference Malekzadeh J, Shafaee H, Behnam H, Mirhaghi A. The effect of Cincinnati prehospital stroke scale on telephone triage of stroke patients: evidence-based practice in emergency medical services. Int J Evid Based Healthc. 2015;13(2):87–92.CrossRef Malekzadeh J, Shafaee H, Behnam H, Mirhaghi A. The effect of Cincinnati prehospital stroke scale on telephone triage of stroke patients: evidence-based practice in emergency medical services. Int J Evid Based Healthc. 2015;13(2):87–92.CrossRef
25.
go back to reference Clawson JJ, Scott G, Gardett I, Youngquist S, Taillac P, Fivaz C, et al. Predictive ability of an emergency medical dispatch stroke diagnostic tool in identifying hospital-confirmed strokes. J Stroke Cerebrovasc Dis. 2016;25(8):2031–42.CrossRef Clawson JJ, Scott G, Gardett I, Youngquist S, Taillac P, Fivaz C, et al. Predictive ability of an emergency medical dispatch stroke diagnostic tool in identifying hospital-confirmed strokes. J Stroke Cerebrovasc Dis. 2016;25(8):2031–42.CrossRef
26.
go back to reference Krebes S, Ebinger M, Baumann AM, Kellner PA, Rozanski M, Doepp F, et al. Development and validation of a dispatcher identification algorithm for stroke emergencies. Stroke. 2012;43(3):776–81.CrossRef Krebes S, Ebinger M, Baumann AM, Kellner PA, Rozanski M, Doepp F, et al. Development and validation of a dispatcher identification algorithm for stroke emergencies. Stroke. 2012;43(3):776–81.CrossRef
27.
go back to reference Wilmer I, Chalk G, Davies GE, Weaver AE, Lockey DJ. Air ambulance tasking: mechanism of injury, telephone interrogation or ambulance crew assessment? Emerg Med J. 2015;32(10):813–6.CrossRef Wilmer I, Chalk G, Davies GE, Weaver AE, Lockey DJ. Air ambulance tasking: mechanism of injury, telephone interrogation or ambulance crew assessment? Emerg Med J. 2015;32(10):813–6.CrossRef
28.
go back to reference Ball SJ, Williams TA, Smith K, Cameron P, Fatovich D, O'Halloran KL, et al. Association between ambulance dispatch priority and patient condition. Emerg Med Australas. 2016;28(6):716–24.CrossRef Ball SJ, Williams TA, Smith K, Cameron P, Fatovich D, O'Halloran KL, et al. Association between ambulance dispatch priority and patient condition. Emerg Med Australas. 2016;28(6):716–24.CrossRef
29.
go back to reference Ek B, Edstrom P, Toutin A, Svedlund M. Reliability of a Swedish pre-hospital dispatch system in prioritizing patients. Int Emerg Nurs. 2013;21(2):143–9.CrossRef Ek B, Edstrom P, Toutin A, Svedlund M. Reliability of a Swedish pre-hospital dispatch system in prioritizing patients. Int Emerg Nurs. 2013;21(2):143–9.CrossRef
30.
go back to reference Leopardi M, Sommacampagna M. Emergency nursing staff dispatch: sensitivity and specificity in detecting prehospital need for physician interventions during ambulance transport in Rovigo emergency ambulance service, Italy. Prehosp Disaster Med. 2013;28(5):523–8.CrossRef Leopardi M, Sommacampagna M. Emergency nursing staff dispatch: sensitivity and specificity in detecting prehospital need for physician interventions during ambulance transport in Rovigo emergency ambulance service, Italy. Prehosp Disaster Med. 2013;28(5):523–8.CrossRef
31.
go back to reference Riou M, Ball S, Williams TA, Whiteside A, et al. The linguistic and interactional factors impacting recognition and dispatch in emergency calls for out-of-hospital cardiac arrest: a mixed-method linguistic analysis study protocol. BMJ Open. 2017;7:e016510.CrossRef Riou M, Ball S, Williams TA, Whiteside A, et al. The linguistic and interactional factors impacting recognition and dispatch in emergency calls for out-of-hospital cardiac arrest: a mixed-method linguistic analysis study protocol. BMJ Open. 2017;7:e016510.CrossRef
32.
go back to reference Buck BH, Starkman S, Eckstein M, et al. Dispatcher recognition of stroke using the National Academy Medical Priority Dispatch System. Stroke. 2009;40:2027–30.CrossRef Buck BH, Starkman S, Eckstein M, et al. Dispatcher recognition of stroke using the National Academy Medical Priority Dispatch System. Stroke. 2009;40:2027–30.CrossRef
33.
go back to reference Chenaitia H, Lefevre O, Ho V, et al. Emergency medical service in the stroke chain of survival. Eur J Emerg Med. 2013;20:39–44.CrossRef Chenaitia H, Lefevre O, Ho V, et al. Emergency medical service in the stroke chain of survival. Eur J Emerg Med. 2013;20:39–44.CrossRef
34.
go back to reference Thomas SH, Biddinger PD. Helicopter trauma transport: an overview of recent outcomes and triage literature. Curr Opin Anaesthesiol. 2003;16:153e8.CrossRef Thomas SH, Biddinger PD. Helicopter trauma transport: an overview of recent outcomes and triage literature. Curr Opin Anaesthesiol. 2003;16:153e8.CrossRef
35.
go back to reference Kurola J, Wangel M, Uusaro A, et al. Paramedic helicopter emergency service in rural Finland do benefits justify the cost? Acta Anaesthesiol Scand. 2002;46:779e84.CrossRef Kurola J, Wangel M, Uusaro A, et al. Paramedic helicopter emergency service in rural Finland do benefits justify the cost? Acta Anaesthesiol Scand. 2002;46:779e84.CrossRef
36.
go back to reference Oppe S, De Charro FT. The effect of medical care by a helicopter trauma team on the probability of survival and the quality of life of hospitalised victims. Accid Anal Prev. 2001;33:129e38.CrossRef Oppe S, De Charro FT. The effect of medical care by a helicopter trauma team on the probability of survival and the quality of life of hospitalised victims. Accid Anal Prev. 2001;33:129e38.CrossRef
37.
go back to reference Frankema SP, Ringburg AN, Steyerberg EW, et al. Beneficial effect of helicopter emergency medical services on survival of severely injured patients. Br J Surg. 2004;91:1520e6.CrossRef Frankema SP, Ringburg AN, Steyerberg EW, et al. Beneficial effect of helicopter emergency medical services on survival of severely injured patients. Br J Surg. 2004;91:1520e6.CrossRef
38.
go back to reference Mann NC, Schmidt TA, Cone DC. Defining research criteria to characterize medical necessity in emergency medical services: a consensus among experts at the Neely Conference. Prehospital Emerg Care Off J Natl Assoc EMS Physicians Natl Assoc State EMS Dir. 2004;8(2):138–53. Mann NC, Schmidt TA, Cone DC. Defining research criteria to characterize medical necessity in emergency medical services: a consensus among experts at the Neely Conference. Prehospital Emerg Care Off J Natl Assoc EMS Physicians Natl Assoc State EMS Dir. 2004;8(2):138–53.
39.
go back to reference Castrén M, Karlsten R, Lippert F, Christensen EF, Bovim E, et al. Recommended guidelines for reporting on emergency medical dispatch when conducting research in emergency medicine: the Utstein style. Emergency Medical Dispatch expert group at the Utstein Consensus Symposium 2005. Resuscitation. 2008;79(2):193–7.CrossRef Castrén M, Karlsten R, Lippert F, Christensen EF, Bovim E, et al. Recommended guidelines for reporting on emergency medical dispatch when conducting research in emergency medicine: the Utstein style. Emergency Medical Dispatch expert group at the Utstein Consensus Symposium 2005. Resuscitation. 2008;79(2):193–7.CrossRef
40.
go back to reference Fevang E, Lockey D, Thompson J, Lossius HM. Torpo Research Collaboration. The top five research priorities in physician-provided pre-hospital critical care: a consensus report from a European research collaboration. Scand J Trauma Resusc Emerg Med. 201;19:57. Fevang E, Lockey D, Thompson J, Lossius HM. Torpo Research Collaboration. The top five research priorities in physician-provided pre-hospital critical care: a consensus report from a European research collaboration. Scand J Trauma Resusc Emerg Med. 201;19:57.
Metadata
Title
The accuracy of medical dispatch - a systematic review
Authors
K. Bohm
L. Kurland
Publication date
01-12-2018
Publisher
BioMed Central
DOI
https://doi.org/10.1186/s13049-018-0528-8

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