scholarly journals Information layering to de-clutter displays for emergency ambulance dispatch

2006 ◽  
Author(s):  
Jared Hayes ◽  
Antoni Moore ◽  
B. L. William Wong
Keyword(s):  
Ambulance Dispatch ◽  
Emergency Ambulance

scholarly journals Ambulance dispatch of older patients following primary and secondary telephone triage in metropolitan Melbourne, Australia: a retrospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e042351
Author(s):  
Kathryn Eastwood ◽  
Dhanya Nambiar ◽  
Rosamond Dwyer ◽  
Judy A Lowthian ◽  
Peter Cameron ◽  
...  
Keyword(s):  
Cohort Study ◽  
Older Adult ◽  
Retrospective Cohort Study ◽  
Older Patients ◽  
Retrospective Cohort ◽  
Vital Signs ◽  
Telephone Triage ◽  
Ambulance Dispatch ◽  
Emergency Ambulance ◽  
Primary Triage

BackgroundMost calls to ambulance result in emergency ambulance dispatch (direct dispatch) following primary telephone triage. Ambulance Victoria uses clinician-led secondary telephone triage for patients identified as low-acuity during primary triage to refer them to alternative care pathways; however, some are returned for ambulance dispatch (secondary dispatch). Older adult patients are frequent users of ambulance services; however, little is known about the appropriateness of subsequent secondary dispatches.ObjectivesTo examine the appropriateness of secondary dispatch through a comparison of the characteristics and ambulance outcomes of older patients dispatched an emergency ambulance via direct or secondary dispatch.DesignA retrospective cohort study of ambulance patient data between September 2009 and June 2012 was conducted.SettingThe secondary telephone triage service operated in metropolitan Melbourne, Victoria, Australia during the study period.ParticipantsThere were 90 086 patients included aged 65 years and over who had an emergency ambulance dispatch via direct or secondary dispatch with one of the five most common secondary dispatch paramedic diagnoses.Main outcome measuresDescriptive analyses compared characteristics, treatment and transportation rates between direct and secondary dispatch patients.ResultsThe dispatch groups were similar in demographics, vital signs and hospital transportation rates. However, secondary dispatch patients were half as likely to be treated by paramedics (OR 0.51; CI 0.48 to 0.55; p<0.001). Increasing age was associated with decreasing treatment (p<0.005) and increasing transportation rates (p<0.005).ConclusionSecondary triage could identify patients who would ultimately be transported to an emergency department. However, the lower paramedic treatment rates suggest many secondary dispatch patients may have been suitable for referral to alternative low-acuity transport or referral options.

scholarly journals Knowledge discovery from emergency ambulance dispatch during COVID-19: A case study of Nagoya City, Japan

2021 ◽  
pp. 103743
Author(s):  
Essam A. Rashed ◽  
Sachiko Kodera ◽  
Hidenobu Shirakami ◽  
Ryotetsu Kawaguchi ◽  
Kazuhiro Watanabe ◽  
...  
Keyword(s):  
Knowledge Discovery ◽  
Ambulance Dispatch ◽  
Emergency Ambulance

scholarly journals Emergency Ambulance Dispatch and Drive Times: An Analysis of Prehospital Vehicular Response in the Kingdom of Bhutan

2019 ◽  
Vol 34 (s1) ◽  
pp. s125-s125
Author(s):  
Jenevieve Kincaid ◽  
Charles Mize ◽  
Mila Dorji
Keyword(s):  
Emergency Response ◽  
Complete Data ◽  
Emergency Vehicle ◽  
Response Data ◽  
Medical Response ◽  
Ambulance Dispatch ◽  
Significant Difference ◽  
Emergency Ambulance ◽  
Activation Times ◽  
National Emergency

Introduction:The Kingdom of Bhutan is a small, mountainous country with limited financial resources. Its population is scattered in hard-to-reach villages with poor road access. Ambulance drivers piloting Toyota Landcruisers provide the majority of the country’s emergency response and are dispatched by the national emergency response center (Health Help Service/112) to calls in the nation’s twenty districts.Aim:By collecting and analyzing prehospital response data, we aimed to describe Bhutanese emergency medical response (EMS) ambulance activities and make system-wide recommendations to improve the speed of emergency vehicle dispatch, reduce the time between ambulance activation and ambulance arrival on scene, and adequately describe emergency vehicle drive time as it relates to distance driven.Methods:The following data was compiled in Excel: Dispatch center phone records, EMS ambulance activation times, drive times, vehicle geospatial data, and written records of ambulance drivers. No identifiable data was collected.Inclusion Criteria: All prehospital calls from 2017 and 2018 where complete data was available.Exclusion Criteria: Complete data unavailable, i.e. geographic data without a matching call or report.Statistical Tools: SPSS Statistics Version 25, NVivo 12-12.2.0.3262.Results:Preliminary analysis of the data shows a significant difference between data collected and data previously reported, the speed of emergency vehicular response and dispatch, drive times, and distance traveled. Facility transfer rather than scene response was found to take more time.Discussion:Due to adverse road conditions, lengthy drive times, and an inadequate number of personnel and satellite ambulance locations, we recommend optimizing ambulance location using an optimization model that will minimize the number of ambulances needed and maximize response time. Future considerations may include adding a ground arm to the Bhutan Emergency Aeromedical Retrieval team, or a second aeromedical team in the eastern part of the country.

scholarly journals Emergency Ambulance Dispatch: Is there a Case for Triage?

2002 ◽  
Vol 95 (3) ◽  
pp. 126-129 ◽  
Author(s):  
S Thakore ◽  
E A Mcgugan ◽  
W Morrison
Keyword(s):  
Ambulance Dispatch ◽  
Emergency Ambulance

scholarly journals PP13 The NHS pathways (NHSP) medical call triage system and new ‘nature of call’ telephone screening tool, employed prior to NHSP, can accurately identify high acuity patients: analysis of sensitivity and specificity using routine ambulance service data

2019 ◽  
Vol 36 (1) ◽  
pp. e5.3-e6
Author(s):  
Jonathan Green ◽  
Sean Ewings ◽  
Richard Wortham ◽  
Bronagh Walsh
Keyword(s):  
Sensitivity And Specificity ◽  
Screening Tool ◽  
High Sensitivity ◽  
Ambulance Service ◽  
Triage System ◽  
Ambulance Dispatch ◽  
Emergency Ambulance ◽  
High Acuity ◽  
Clinical Records ◽  
Service Data

BackgroundThe NHS Pathways (NHSP) medical call triage system is employed by UK ambulance services. One function is to identify a broad category of ‘high-acuity calls’, distinguishing them from those that do not require an emergency response. A new pre-triage screening tool, Nature of Call (NoC), designed to augment NHSP could be employed as a rapid initial sieve of broad acuity.ObjectivesTo identify the accuracy of NHSP (and NoC) in recognising patients who require an emergency ambulance response (and therefore those who may not).MethodsDiagnostic accuracy. The sample is a retrospective cohort of consecutive calls, over a 4 month period, to a UK ambulance service. Sensitivity and specificity were determined, comparing allocated NoC and NHS Pathways priority dispositions with a composite reference standard comprised of administered medications, procedures, observations and clinical impressions associated with high-acuity, as recorded on ambulance electronic Patient Clinical Records.ResultsA total of 1 87 408 emergency calls were received. Of these, 71 373 were allocated both NoC and NHSP priority dispositions and were associated with electronic Patient Clinical Records. 40 997 (57%) of these patients met the high-acuity reference criteria. NHSP, sensitivity=98.1% (95% CI 98.0 to 98.2); specificity=5.9% (95% CI 5.6 to 6.1). NoC, sensitivity=84.0% (95% CI 83.7 to 84.4); specificity=26.5% (95% CI 26.0 to 27.0).ConclusionsNHSP is effective in identifying high-acuity patients (as is NoC). Sensitivity analysis therefore supports the this function of NHSP and NoC/NHSP to inform initial ambulance dispatch decisions, particularly if NoC categorisation is reviewed in the light of subsequent NHSP triage. However, both systems appear to achieve high sensitivity by also allocating most low-acuity calls to high-acuity categories. This significantly restricts operational application. Only one quarter of low-acuity calls are allocated the lowest priority category by NoC and one-in-seventeen by NHSP, severely restricting the group likely to be considered for alternative care pathways.

scholarly journals A novel approach for managing the growing demand for ambulance services by low-acuity patients

2016 ◽  
Vol 40 (4) ◽  
pp. 378 ◽  
Author(s):  
Kathryn Eastwood ◽  
Amee Morgans ◽  
Karen Smith ◽  
Angela Hodgkinson ◽  
Gareth Becker ◽  
...  
Keyword(s):  
Emergency Services ◽  
Service Providers ◽  
Response Times ◽  
Telephone Triage ◽  
Skill Levels ◽  
Ambulance Dispatch ◽  
Novel Approach ◽  
Emergency Ambulance ◽  
Using Data ◽  
Australian Bureau Of Statistics

Objective The aim of the present study was to describe the Ambulance Victoria (AV) secondary telephone triage service, called the Referral Service (RS), for low-priority patients calling triple zero. This service provides alternatives to ambulance dispatch, such as doctor or nurse home visits. Methods A descriptive epidemiological review of all the cases managed between 2009 and 2012 was conducted, using data from AV case records, the Victorian Admitted Episodes Dataset and the Australian Bureau of Statistics. Cases were reviewed for patient demographics, condition, final disposition and RS outcome. Results In all, 107148 cases were included in the study, accounting for 10.3% of the total calls for ambulance attendance. Median patient age was 54 years and 55% were female. Geographically based socioeconomic status was associated with the rate of calls to the RS (r = –0.72; 95% confidence interval CI –0.104, –0.049; P < 0.001). Abdominal pain and back symptoms were the most common patient problems. Although 68% of patients were referred to the emergency department, only 27.6% of the total cases were by emergency ambulance; the remainder were diverted to non-emergency ambulance or the patient’s own private transport. The remaining 32% of cases were referred to alternative service providers or given home care advice. Conclusions This paper describes the use of an ongoing secondary triage service, providing an effective strategy for managing emergency ambulance demand. What is known about the topic? Some calls to emergency services telephone numbers for ambulance assistance consist of cases deemed to be low-acuity that could potentially be better managed in the primary care setting. The demand on ambulance resources is increasing each year. Secondary telephone triage systems have been trialled in ambulance services in the US and UK with minimal success in terms of overall impact on ambulance resourcing. What does this paper add? This study describes a model of secondary telephone triage in the ambulance setting that has provided an effective way to divert patients to more suitable forms of health care to meet their needs. What are the implications for practitioners? The implications for practitioners are vast. Some of the issues that currently face paramedics include: fatigue because of high workloads; skills decay because of a lack of exposure to patients requiring intervention with skills the paramedics have, as well as a lack of time for paramedics to practice these skills during their downtime; and decreasing job satisfaction linked to both these factors. Implications for patients include quicker response times because more ambulances will be available to respond and increased patient safety because of decreased fatigue and higher skill levels in paramedics.

Short-Term Exposure To Particulate Matter And Emergency Ambulance Dispatch For Acute Illness In Japan

2015 ◽  
Vol 2015 (1) ◽  
pp. 678
Author(s):  
Saira Tasmin ◽  
Kayo Ueda ◽  
Phung Vera Ling Hui ◽  
Mizuki Ooishi ◽  
Yasukouchi Shusuke ◽  
...  
Keyword(s):  
Particulate Matter ◽  
Acute Illness ◽  
Short Term ◽  
Ambulance Dispatch ◽  
Short Term Exposure ◽  
Emergency Ambulance

scholarly journals ‘Primary care sensitive’ situations that result in an ambulance attendance: a conversation analytic study of UK emergency ‘999’ call recordings

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023727 ◽  
Author(s):  
Matthew James Booker ◽  
Ali R G Shaw ◽  
Sarah Purdy ◽  
Rebecca Barnes
Keyword(s):  
Primary Care ◽  
Ambulance Dispatch ◽  
Emergency Ambulance ◽  
Life Threatening ◽  
Medical Emergencies ◽  
Telephone Calls ◽  
Alternative Question ◽  
Personal Accounts ◽  
Access To Knowledge ◽  
Question Formats

ObjectivesTo explore common features of conversations occurring in a sample of emergency calls that result in an ambulance dispatch for a ‘primary care sensitive’ situation, and better understand the challenges of triaging this cohort.DesignA qualitative study, applying conversation analytic methods to routinely recorded telephone calls made through the ‘999’ system for an emergency ambulance. Cases were identified by a primary care clinician, observing front-line UK ambulance service shifts. A sample of 48 ‘999’ recordings were analysed, corresponding to situations potentially amenable to primary care management.ResultsThe analysis focuses on four recurring ways that speakers use talk in these calls. Progress can be impeded when call-taker’s questions appear to require callers to have access to knowledge that is not available to them. Accordingly, callers often provide personal accounts of observed events, which may be troublesome for call-takers to ‘code’ and triage. Certain question formats—notably ‘alternative question’ formats—appear particularly problematic. Callers deploy specific lexical, grammatical and prosodic resources to legitimise the contact as ‘urgent’, and ensure that their perception of risk is conveyed. Difficulties encountered in the triage exchange may be evidence of misalignment between organisational and caller perceptions of the ‘purpose’ of the questions.ConclusionsPrevious work has focused on exploring the presentation and triage of life-threatening medical emergencies. Meaningful insights into the challenges of EMS triage can also be gained by exploring calls for ‘primary care sensitive’ situations. The highly scripted triage process requires precise, ‘codeable’ responses to questions, which can create challenges when the exact urgency of the problem is unclear to both caller and call-taker. Calling on behalf of someone else may compound this complexity. The aetiology of some common interactional challenges may offer a useful frame for future comparison between calls for ‘primary care sensitive’ situations and life-threatening emergencies.

Can ambulance dispatch categories discriminate traffic incidents that do/do not require a lights and sirens response?

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ellen Ceklic ◽  
Hideo Tohira ◽  
Judith Finn ◽  
Deon Brink ◽  
Paul Bailey ◽  
...  
Keyword(s):  
Design Methodology ◽  
Predictor Variable ◽  
Outcome Variable ◽  
Unique Contribution ◽  
Traffic Incidents ◽  
Content Type ◽  
Ambulance Dispatch ◽  
Emergency Ambulance ◽  
Referent Group ◽  
Practical Implications

PurposeTraffic incidents vary considerably in their severity, and the dispatch categories assigned during emergency ambulance calls aim to identify those incidents in greatest need of a lights and sirens (L&S) response. The purpose of this study was to determine whether dispatch categories could discriminate between those traffic incidents that do/do not require an L&S response.Design/methodology/approachA retrospective cohort study of ambulance records was conducted. The predictor variable was the Traffic/Transportation dispatch categories assigned by call-takers. The outcome variable was whether each incident required an L&S response. Possible thresholds for identifying dispatch categories that require an L&S response were developed. Sensitivity and specificity were calculated for each threshold.FindingsThere were 17,099 patients in 13,325 traffic incidents dispatched as Traffic/Transportation over the study period. “Possible death at scene” ‘had the highest odds (OR 22.07, 95% CI 1.06–461.46) and “no injuries” the lowest odds (OR 0.28 95% CI 0.14–0.58) of requiring an L&S response compared to the referent group. The area under the ROC curve was 0.65, 95% CI [0.64, 0.67]. It was found that Traffic/Transportation dispatch categories allocated during emergency ambulance calls had limited ability to discriminate those incidents that do/do not require an L&S response to the scene of a crash.Originality/valueThis research makes a unique contribution, as it considers traffic incidents not as a single entity but rather as a number of dispatch categories which has practical implications for those emergency medical services dispatching ambulances to the scene.

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