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Triage By Emergency Medical Dispatchers

Published online by Cambridge University Press:  28 June 2012

Samuel J. Stratton*
Affiliation:
Emergency Department, Saint Mary Medical Center, and Long Beach Emergency Medical Services System, Long Beach, Calif.
*
Los Angeles County EMS Agency, Paramedic, Training Institute, PO Box 268, Torrance, CA 90507-0268USA

Abstract

Purpose:

This study is an evaluation of the ability of medically trained and controlled emergency medical dispatchers to use telephone triage techniques to direct the appropriate prehospital unit to an emergency scene.

Methods:

Emergency dispatchers, educated in a formal emergency medical dispatch program, were assigned one of four triage priorities to incoming 9-1-1 calls. The actual field management delivered for each patient was compared with the dispatcher's triage to determine the appropriateness of triage.

Results:

A total of 1,045 consecutive calls were reviewed with 74.4% sorted as needing advanced life support (ALS) units on scene; 65.3% (95% CI, 61.9 to 68.6%) of these calls required ALS intervention. A total of 3.4% of the runs sorted to the non-ALS response groups were identified to have required ALS intervention. Comparing the need for ALS intervention, a significant difference was found between the triage groups.

Conclusion:

Emergency medical dispatchers, using a formal system for telephone triage, are able to direct appropriate prehospital resources to the emergency scene.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1992

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References

1. Clawson, JJ: Emergency Medical Dispatching. In: Principles of EMS Systems. Rousch, WR, Aranosian, RD, Blair, TMH, et al. (eds): Dallas: American College of Emergency Physicians 1989, pp 119133.Google Scholar
2. Slovis, CM, Carruth, TB, Seitz, WJ, et al. : A priority dispatch system for emergency medical services. Ann Emerg Med 1985;14:10551060.CrossRefGoogle ScholarPubMed
3. Braun, O, McCallion, R, Fazackerley, J: Characteristics of midsized urban EMS systems. Ann Emerg Med 1990;19:536546.CrossRefGoogle ScholarPubMed
4. Narad, RA: Emergency medical services system design. Emerg Med Clinics 1990;8:115.CrossRefGoogle ScholarPubMed
5. Brismar, B, Dahlgren, B, Larsson, J: Training of emergency dispatch personnel in Sweden. Crit Care Med 1984;12:679680.CrossRefGoogle ScholarPubMed
6. American College of Emergency Physicians: Guidelines for emergency medical services systems. Ann Emerg Med 1988;17:742745.CrossRefGoogle Scholar
7. Clawson, JJ: Dispatch priority training—Strengthening the weak link. JEMS 1981;6:3235.Google Scholar
8. Clawson, JJ, Dernocour, KB: Principles of Emergency Medical Dispatch. Englewood Cliffs, N.J.: Prentice Hall 1988, pp 4265.Google Scholar
9. Hauswald, M, Drake, C: Innovations in emergency medical services systems. Emerg Med Clinics 1990;8:135144.CrossRefGoogle ScholarPubMed
10. Gibson, G: Measures of emergency ambulance effectiveness: Unmet need and inappropriate use. Ann Emerg Med 1977;6:389392.Google ScholarPubMed
11. Clawson, JJ: The red light-and-siren response. JEMS 1981:6:3435.Google Scholar
12. Clawson, JJ: The maximal response disease–Red lights and siren syndrome in priority dispatching. JEMS 1987:12:2831.Google Scholar
13. Clawson, JJ, Dernocour, KB: Principles of Emergency Medical Dispatch. Englewood Cliffs, N.J.: Prentice Hall 1988, p 7.Google Scholar
14. Eisenberg, MS, Carter, W, Hallstrom, A, et al. : Identification of cardiac arrest by emergency dispatchers. Am J Emerg Med 1986:4:299301.CrossRefGoogle ScholarPubMed
15. Carter, W, Eisenberg, M, Hallstrom, A, et al. : Development and implementation of emergency CPR instruction via telephone. Ann Emerg Med 1984;13:695700.CrossRefGoogle ScholarPubMed
16. Eisenberg, M, Hallstrom, A, Carter, W, et al. : Emergency CPR instruction via telephone. Am J Pub Health 1984;75:4749.CrossRefGoogle Scholar
17. Kellerman, AL, Hackman, BB, Somes, G: Dispatcherassisted cardiopulmonary resuscitation: Validation of efficacy. Circulation 1989:80:12311239.CrossRefGoogle Scholar
18. Culley, LL, Clark, JJ, Eisenberg, MS, et al. : Dispatcherassisted telephone CPR: Common delays and time standards for delivery. Ann Emerg Med 1991;20:362366.CrossRefGoogle ScholarPubMed
19. Kallsen, G, Nabors, MD: The use of priority medical dispatch to distinguish between high- and low-risk patients. Ann Emerg Med 1990;19:458459. Abstract.Google Scholar
20. Curka, PA, Pepe, PE, Ginger, RC, et al. : Computeraided EMS priority dispatch: Ability of a computerized triage system to safely spare paramedics from responses not requiring advanced life support. Ann Emerg Med 1991;20:446. Abstract.Google Scholar
21. Pepe, PE, Mattox, KL, Curka, PA, et al. : Computeraided EMS priority dispatch triage system. Prehospital and Disaster Medicine 1991;6:197. Abstract.Google Scholar
22. Clawson, JJ: Emergency Medical Dispatcher Training Program. 6th revision. Salt Lake, Utah: Utah State Department of Health, 1986.Google Scholar
23. Prehospital Care Policy Manual. Los Angeles: Los Angeles County Department of Health Services 1986, Reference #808.Google Scholar
24. California Code of Regulations, 1985, Title 22, div 9. Prehospital Emergency Medical Services, section 100141–4: Scope of practice of Emergency Medical Technician-Paramedic (EMT-P).Google Scholar
25. Keene, K: Promises, promises: Does EMD really work? JEMS 1990;19:2529.Google ScholarPubMed